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NPI Code Detail

MEDICARE: DR. JOSEPH BLEVINS OD

MEDICARE:  DR. JOSEPH  BLEVINS  OD
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
1152W00000XOptometristOPT.007083OH

General Provider Information

NPI Number : 1861124257
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH BLEVINS OD
Provider Business Mailing Address
First Line : 369 WHITTIER AVE NW
Second Line :
City : NORTH CANTON
State : OH
Zip : 44720-2258
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 907 SCHNEIDER ST SE
Second Line :
City : NORTH CANTON
State : OH
Zip : 44720-3774
Country : US
Telephone Number : 330-499-1494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2022
Last Update Date : 06/26/2022

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Directions to “ DR. JOSEPH BLEVINS OD” Practice Location

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