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Individual

DR. MARY LARTEY BLANKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1700 AVENUE E, BIRMINGHAM, AL 35218-1543
(205) 788-3321
(205) 241-5260
Mailing address
1700 AVENUE E, BIRMINGHAM, AL 35218-1543
(205) 788-3321
(205) 241-5260

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
00011805
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051516611
BLUE CROSS BLUE SHIELD
AL
05
303739090
AL
Enumeration date
01/04/2006
Last updated
02/18/2011
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