Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Travis Wayne Blalock, MD

Individual provider MOHS-Micrographic Surgery Physician · NPI 1710195003

Dr. Travis Wayne Blalock, MD is a Dermatology in Oklahoma City, Oklahoma. Graduated from Mercer University School of Medicine in 2007, 19 years ago. Practices with The Emory Clinic Inc, a 3,500-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and Georgia.

Years since qualifying
19
Trained at
Mercer University School of Medicine
Licensed in
CA, GA
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

619 NE 13th St
Oklahoma City, OK 73104-5001
Phone: (405) 271-6110
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence 73100 (GA)
Procedural Dermatology Physician Taxonomy 207NS0135X · Licence A116875 (CA)

Record details

NPI number1710195003
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 18, 2007
Last updated in NPPESFebruary 12, 2021
Certification dateFebruary 12, 2021
Mailing address1525 Clifton Rd Ne Ste 112a, Atlanta, GA 30322-4200

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolMERCER UNIVERSITY SCHOOL OF MEDICINE
Graduated 2007 (19 years in practice)
Group practice The Emory Clinic Inc — 3500 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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