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NPI Code Detail

MEDICARE: ANTHONY GABRIEL BLEVINS JR.

MEDICARE: ANTHONY GABRIEL BLEVINS JR.
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1689530016
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY GABRIEL BLEVINS JR.
Provider Business Mailing Address
First Line : 5563 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45429-2225
Country : US
Telephone Number : 937-291-2300
Fax Number : 937-291-2303
Provider Business Practice Location Address
First Line : 5563 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45429-2225
Country : US
Telephone Number : 937-291-2300
Fax Number : 937-291-2303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2025
Last Update Date : 12/30/2025

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