Individual
JEFFREY S BLAKESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
20 S PARK ST, MADISON, WI 53715-1348
(608) 287-2090
Mailing address
7974 UW HEALTH CT, MIDDLETON, WI 53562-5531
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
74286-21
WI
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
74286-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2019
Last updated
12/10/2024
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