Individual
TOMMY D BLEDSOE
Active
Individual
TOMMY D BLEDSOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
041730
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02076817
AMERIGROUP
GA
01
—
1001399
WELLCARE
GA
01
—
P01366671
RR MEDICARE
GA
Enumeration date
07/18/2006
Last updated
01/24/2024
Update your record
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