Individual
TOMMY D BLEDSOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 GI MADDOX PKWY, CHATSWORTH, GA 30705-4008
(706) 695-1992
(866) 348-6516
Mailing address
800 GI MADDOX PKWY, CHATSWORTH, GA 30705-4008
(706) 695-1992
(866) 348-6516
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
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