Provider Demographics
NPI:1811639586
Name:BLEDSOE, WILLIAM STEPHEN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:BLEDSOE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 BUCKNOLL CV
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32266-3182
Mailing Address - Country:US
Mailing Address - Phone:904-535-8777
Mailing Address - Fax:
Practice Address - Street 1:1385 AMELIA PLZ
Practice Address - Street 2:
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-1998
Practice Address - Country:US
Practice Address - Phone:904-261-5306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58975183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist