Provider Demographics
NPI:1730718016
Name:YOUNGBLOOD, WESLEY WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:WAYNE
Last Name:YOUNGBLOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35914
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-1201
Mailing Address - Country:US
Mailing Address - Phone:888-488-8289
Mailing Address - Fax:
Practice Address - Street 1:1301 MATTEC DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-7300
Practice Address - Country:US
Practice Address - Phone:513-454-7246
Practice Address - Fax:513-986-5069
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.15258207L00000X
OH35.152584208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology