Individual
THOMAS J BLASTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
8433 HARCOURT RD STE 100, INDIANAPOLIS, IN 46260-2193
(317) 583-7600
Mailing address
250 W 96TH ST # 520, INDIANAPOLIS, IN 46260-1316
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10000823A
IN
Other
Enumeration date
07/14/2006
Last updated
09/03/2019
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