| Doctor Name: | BRIAN BLINDT |
| NPI Number: | 1730422825 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 3144-23 |
| Business Practice Address: | 2418 Brewery Rd Cross Plains, WI - 535289470 |
| Business Phone Number: | 6087983344 |
| Business Fax Number: | 6088330999 |
| Mailing Address: | 7974 Uw Health Ct, MIDDLETON |
| State: | WI |
| Postal Code: | 535625531 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/27/2013 |
| NPI Last Update Date: | 12/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 3144-23 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |