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CLINTON JED BLAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
3500 PURDY RD, HUNTINGDON, TN 38344-8050
(731) 986-2536
Mailing address
3500 PURDY RD, HUNTINGDON, TN 38344-8050
(541) 731-4672

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA161186
OR
363A00000X
Physician Assistant
Primary
PA892
TN

Other

Enumeration date
01/13/2006
Last updated
02/16/2022
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