Individual
DR. HAROLD W BLEVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3999 DUTCHMANS LN, SUITE #3A, SUBURBAN PLAZA ONE, LOUISVILLE, KY 40207-4714
(502) 897-7300
(502) 897-3332
Mailing address
3999 DUTCHMANS LN, SUITE #3A, SUBURBAN PLAZA ONE, LOUISVILLE, KY 40207-4714
(502) 897-7300
(502) 897-3332
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01053441A
IN
207Y00000X
Otolaryngology Physician
Primary
16173
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000045754
ANTHEM NUMBER
—
05
—
100007640B
—
IN
01
—
2351301
AETNA NUMBER
—
01
—
2442110000
PASSPORT ADVANTAGE
KY
01
—
2529793001
CIGNA NUMBER
—
01
—
406031019
RAILROAD MEDICARE
—
01
—
50000416
KENTUCKY PASSPORT #
KY
01
—
5000416
WORKERS COMP
—
01
—
610889380100
CARESOURCE
—
05
—
64161730
—
KY
Enumeration date
05/05/2006
Last updated
07/21/2011
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