Individual
JOHN D BLIZZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 NE NEFF RD, BEND, OR 97701-6015
(541) 388-1636
(541) 388-1719
Mailing address
PO BOX 1420, REDMOND, OR 97756-0400
(541) 388-1636
(541) 388-1719
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD20638
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134042
—
OR
Enumeration date
07/20/2006
Last updated
02/14/2012
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