Individual
BLAKE ALEXANDER MEDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
204 SHAVER DR, TALBOTT, TN 37877-8552
(423) 581-7040
(423) 581-9563
Mailing address
204 SHAVER DR, TALBOTT, TN 37877-8552
(423) 581-7040
(423) 581-9563
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4617
TN
Other
Enumeration date
06/25/2021
Last updated
06/25/2021
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