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NPI Code Detail

MEDICARE: DR. JOSEPH ROBERT BLEDSOE MD

MEDICARE: DR. JOSEPH ROBERT 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
1207P00000XEmergency Medicine Physician6353628-1205UT

General Provider Information

NPI Number : 1760656391
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH ROBERT BLEDSOE MD
Provider Business Mailing Address
First Line : PO BOX 27128
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84127-0128
Country : US
Telephone Number : 801-442-5271
Fax Number :
Provider Business Practice Location Address
First Line : 5373 S GREEN ST
Second Line :
City : MURRAY
State : UT
Zip : 84123-4680
Country : US
Telephone Number : 801-442-5271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2008
Last Update Date : 06/09/2026

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