MEDICARE: MARY CLAIRE BLEDSOE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	33899	CO
2	208000000X	Pediatrics Physician	E-18651	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346232055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY CLAIRE BLEDSOE MD

Provider Business Mailing Address
First Line	:	PO BOX 4283
Second Line	:
City	:	EAGLE
State	:	CO
Zip	:	81631-4283
Country	:	US
Telephone Number	:	970-471-3947
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CHILDRENS WAY # 512-1
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202-3500
Country	:	US
Telephone Number	:	501-364-1100
Fax Number	:	501-364-4082

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	03/31/2026

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Directions to “ MARY CLAIRE BLEDSOE MD” Practice Location

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