| Harold Blankenship, D.o., F.a.c.o.i. | |
|
1905 W 32nd St Ste. 407 Joplin MO 64804-1529 | |
| (417) 782-2125 | |
| (417) 782-2145 |
| Full Name | Harold Blankenship, D.o., F.a.c.o.i. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1905 W 32nd St, Joplin, Missouri |
| Authorized Official Name and Position | Harold Blankenship (MEMBER/OWNER) |
| Authorized Official Contact | 4177822125 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harold Blankenship, D.o., F.a.c.o.i. 1905 W 32nd St Ste. 407 Joplin MO 64804-1529 Ph: (417) 782-2125 | Harold Blankenship, D.o., F.a.c.o.i. 1905 W 32nd St Ste. 407 Joplin MO 64804-1529 Ph: (417) 782-2125 |
| NPI Number | 1841429909 |
|---|---|
| Provider Enumeration Date | 07/10/2009 |
| Last Update Date | 07/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841429909 | NPI | - | NPPES |
| 100183010A | Medicaid | OK | |
| 200312050A | Medicaid | KS | |
| 197311 | Other | ANTHEM | |
| 207291402 | Medicaid | MO | |
| P00215074 | Other | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 2005009945 (Missouri) | Primary |
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