# BLANKENSHIP MEDICAL GROUP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104849116
- **Authorized official:** DR. BRAD E BLANKENSHIP MD (OWNER)
- **Authorized official phone:** (615) 796-0902

## Contact information

- **Practice address:** 306 N CHANCERY ST, MC MINNVILLE, TN 37110-8904
- **Practice address phone:** (931) 507-4500
- **Practice address fax:** (931) 507-4502
- **Mailing address:** PO BOX 330699, MURFREESBORO, TN 37133-0699
- **Mailing address phone:** (931) 507-4500
- **Mailing address fax:** (931) 507-4502

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD17499 | TN | Yes |

## Other

- **Enumeration date:** 07/25/2006
- **Last updated:** 02/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3735031 | — | TN |