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Individual

DR. JOHN DAVID BLANKENSHIP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
401 LOWELL DR SE STE 14, HUNTSVILLE, AL 35801-3738
(256) 534-7235
(256) 534-7268
Mailing address
420 LOWELL DR SE STE 103, HUNTSVILLE, AL 35801-3755
(256) 535-5940
(256) 535-5954

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02709
KY
207Q00000X
Family Medicine Physician
Primary
DO630
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64036296
KY
Enumeration date
12/28/2005
Last updated
07/24/2012
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