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General NPI Number Information
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NPI Number | 1548441850
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Entity Type | Organization
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Legal Business Name | DR. HAROLD BLEVINS
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 5129 DIXIE HWY STE 209
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City | LOUISVILLE
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State | KY
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Zip | 40216-1727
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Country | US
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Telephone | 502-447-3265
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Fax | 502-897-3332
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Provider Business Mailing Address
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Address Line | 4001 DUTCHMANS LN STE 2E
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City | LOUISVILLE
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State | KY
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Zip | 40207-4734
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Country | US
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Telephone | 502-897-7300
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Fax | 502-897-3332
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Authorized Official
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Title or Position | OWNER
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Name | DR. HAROLD W BLEVINS
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Credential |
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Telephone | 502-897-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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