Organization
STEPHEN H. BLAYDES, MD
Active
Other names
Optical Experience
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN H. BLAYDES M.D. (OWNER)
(304) 327-8128
Entity
Organization
Contact information
Practice address
1109 W CUMBERLAND RD, BLUEFIELD, WV 24701-4562
(304) 327-8128
Mailing address
PO BOX 1380, BLUEFIELD, WV 24701-1380
(304) 327-8128
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151800000
—
WV
Enumeration date
01/29/2008
Last updated
02/21/2008
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