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Individual

WILLIAM F BLAISDELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1124 MEDICAL PLACE, SEYMOUR, IN 47274
(812) 522-1613
(812) 522-6694
Mailing address
1124 MEDICAL PLACE, SEYMOUR, IN 47274
(812) 522-1613
(812) 522-6694

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01020748
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100328750A
IN
Enumeration date
04/18/2006
Last updated
09/15/2011
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