Individual
SPENCER JUSTIN BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3111
Mailing address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000236A
IN
Other
Enumeration date
12/08/2025
Last updated
01/06/2026
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