Provider Demographics
NPI:1104676154
Name:BLEVINS, SYDNEY KATHERINE (MD)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:KATHERINE
Last Name:BLEVINS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 W CAPITOL AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5603
Mailing Address - Country:US
Mailing Address - Phone:870-656-7361
Mailing Address - Fax:
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:401-793-2695
Practice Address - Fax:401-444-4165
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program