Provider Demographics
NPI:1275761710
Name:TRUEBLOOD, WESLEY EARL (MD)
Entity type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:EARL
Last Name:TRUEBLOOD
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:UNIT 5268 BOX 18TH
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96368-5268
Mailing Address - Country:US
Mailing Address - Phone:098-960-4817
Mailing Address - Fax:
Practice Address - Street 1:UNIT 5268 BOX 18TH
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96368-5268
Practice Address - Country:US
Practice Address - Phone:098-960-4817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5488207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine