Larry Bledsoe (NPI# 1396763702, PAC ID# 2062545213) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1396763702 |
| PAC ID by PECOS | 2062545213 |
| Professional Enrollment ID | I20100809000709 |
| Full Name | Larry Bledsoe |
| Address |
620 W Berry St Fort Wayne IN 46802-2106 |
| Phone Number | 2604246311 |
| Gender | M |
| Medical School | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1978 |
| Primary Specialty | INTERNAL MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 150021 | PARKVIEW REGIONAL MEDICAL CENTER |
| 150047 | ST JOSEPH HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 620 W Berry St, Fort Wayne, IN 46802-2106 | 2604246311 |
| Street Address |
620 W BERRY ST |
| City | FORT WAYNE |
| State | IN |
| Zip | 46802-2106 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nikkiya Fraser | Infectious Disease | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| Tara J Little | Nurse Practitioner | Associated Surgeons and Physicians LLC | 700 Broadway, Fl 2, Fort Wayne, IN 46802-1402 |
| Debra K Brandenberger | Nurse Practitioner | Associated Surgeons and Physicians LLC | 700 Broadway, Fl 2, Fort Wayne, IN 46802-1402 |
| Melissa K Gephart | Nurse Practitioner | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| April Renee Morrison | Infectious Disease | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| Dedrick K. Bowe | Pulmonary Disease | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| Maryann Meo | General Surgery | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| Carrie B Price | Nurse Practitioner | Associated Surgeons and Physicians LLC | 700 Broadway, Fl 2, Fort Wayne, IN 46802-1402 |
| William A Wood | Plastic and Reconstructive Surgery | Lutheran Medical Group LLC | 700 Broadway, Fort Wayne, IN 46802-1402 |
| Glenn Alan Glogas | Undersea and Hyperbaric Medicine | Associated Surgeons and Physicians LLC | 700 Broadway, Fl 2, Fort Wayne, IN 46802-1402 |
| Find all physicians in zip 46802 | |||
| City | FORT WAYNE |
| Zip Code | 46802 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | FORT WAYNE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Larry Bledsoe.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.