Individual
DR. JEFFERY BLAINE ITKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5920 SARATOGA BOULEVARD, SUITE 540, CORPUS CHRISTI, TX 78414-4118
(361) 883-6030
(361) 883-6442
Mailing address
5920 SARATOGA BOULEVARD, SUITE 540, CORPUS CHRISTI, TX 78414-4118
(361) 883-6030
(361) 883-6442
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
15006
NE
207V00000X
Obstetrics & Gynecology Physician
Primary
F6257
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47068796900
—
NE
Enumeration date
08/08/2006
Last updated
04/05/2012
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