Provider Demographics
NPI:1851557235
Name:BLESSINGER, BRIAN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JOSEPH
Last Name:BLESSINGER
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 1028
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-1028
Mailing Address - Country:US
Mailing Address - Phone:812-996-6500
Mailing Address - Fax:812-996-8497
Practice Address - Street 1:709 W 9TH ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-2609
Practice Address - Country:US
Practice Address - Phone:812-996-6500
Practice Address - Fax:812-996-8497
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-01956207X00000X
IN01073002A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNC1543Medicaid
NC5920121Medicaid
IN201184700Medicaid
IN201184700Medicaid
NC5920121Medicaid