Individual
DR. KEVIN W. BLECHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5359 EASTERN AVE, DAVENPORT, IA 52807-2738
(563) 742-5900
(563) 742-5905
Mailing address
5359 EASTERN AVE, DAVENPORT, IA 52807-2738
(563) 742-5900
(563) 742-5905
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02836
IA
207Q00000X
Family Medicine Physician
036-102383
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-102383
—
IL
05
—
1396725768
—
IA
01
—
P00055265
RR MEDICARE
IL
Enumeration date
01/20/2006
Last updated
01/15/2014
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