IndividualActive
Blake Medley
NPI 1043880834 · Physician Assistant · Talbott, TN
Provider details
- NPI number
- 1043880834
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 4617 (TN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
204 Shaver Dr
Talbott, TN 37877-8552
Phone: (423) 581-7040
Fax: (423) 581-9563
Approximate (ZIP-level) locationGet directions
Mailing address
204 Shaver Dr
Talbott, TN 37877-8552
Registry dates
- Enumerated
- 2021-06-25
- Last updated
- 2021-06-25
- Certified
- 2021-06-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.