| J D Blankenship Do Llc | |
|
401 Lowell Dr Se Ste 14 Huntsville AL 35801-3748 | |
| (256) 534-7235 | |
| (256) 534-7268 |
| Full Name | J D Blankenship Do Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 401 Lowell Dr Se, Huntsville, Alabama |
| Authorized Official Name and Position | John David Blankenship (FAMILY PHYSICIAN) |
| Authorized Official Contact | 2566837050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J D Blankenship Do Llc 420 Lowell Dr Se Ste 103 Huntsville AL 35801-3755 Ph: (256) 535-5940 | J D Blankenship Do Llc 401 Lowell Dr Se Ste 14 Huntsville AL 35801-3748 Ph: (256) 534-7235 |
| NPI Number | 1679854269 |
|---|---|
| Provider Enumeration Date | 09/08/2011 |
| Last Update Date | 07/20/2012 |
| Medicare PECOS PAC ID | 9436321577 |
|---|---|
| Medicare Enrollment ID | O20111013000254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679854269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | DO 630 (Alabama) | Primary |
| Provider Name | John Blankenship |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013994342 PECOS PAC ID: 2961441282 Enrollment ID: I20090707000395 |
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