NPI 1053267062

Blake Bostick

Practitioner Physician Assistant Clinton, MS

Practice location

Address: 200 Capitol St, Clinton, MS 39056-4026
Phone: (601) 925-3000

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Registry record

NPI: 1053267062
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Mar 2026
Record last updated: 10 Mar 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.