Provider Demographics
NPI:1851337471
Name:BLOUNT, HOWARD PAUL III (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:PAUL
Last Name:BLOUNT
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HOWARD
Other - Middle Name:P
Other - Last Name:BLOUNT
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 740013
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0013
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:
Practice Address - Street 1:6119 WHITE HORSE RD STE 14
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-3838
Practice Address - Country:US
Practice Address - Phone:864-614-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29340207Q00000X
SC83289207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN080152465OtherRR MEDICARE
TN3815083Medicaid
TN3717545Medicare ID - Type UnspecifiedLEGACY GROUP
TN3815084Medicare ID - Type UnspecifiedLEGACY PIN
TN080152465OtherRR MEDICARE