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Individual

MR. DOUGLAS ANTHONY BLAKELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CAA

Contact information

Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-8880
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000252A
IN
367H00000X
Anesthesiologist Assistant
AA2000013
DC
367H00000X
Anesthesiologist Assistant
AA942
FL

Other

Enumeration date
02/19/2021
Last updated
06/24/2026
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