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Individual
ADAM C. BLANTON
Active
Individual
ADAM C. BLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2775
SC
363A00000X
Physician Assistant
50.004709RX
OH
363A00000X
Physician Assistant
Primary
700
WV
363A00000X
Physician Assistant
PA1983
KY
363A00000X
Physician Assistant
TC366
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0174794
—
OH
05
—
1508258856
—
WV
Enumeration date
02/24/2015
Last updated
01/28/2021
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