Wayne Blevins JR.

NPI #1902803869 in Carlinville, Illinois

Provider Information

NPI Number: 1902803869
Entity Type: Individual
Name: Wayne Blevins JR.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Emergency Medicine
Enumeration Date: Jul 6, 2005
Last Updated: Apr 23, 2015

Practice Location

Address: 11574 RT 108
City: Carlinville
State: Illinois
ZIP Code: 62626-4091
Phone: (217) 854-4319

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Emergency Medicine	207P00000X	Primary
Physician Assistant	363A00000X

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