Individual
MR. HENRY KEILER BLUHM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
304A E 4TH ST, ELDON, MO 65026
(573) 557-2400
(573) 557-2401
Mailing address
1005 SE WALTON BLVD, BENTONVILLE, AR 72712-6775
(479) 254-6734
(479) 254-6836
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-461
AR
363AM0700X
Medical Physician Assistant
0110002717
VA
363AM0700X
Medical Physician Assistant
Primary
2011035886
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011035886
STATE LICENSE
MO
Enumeration date
03/03/2008
Last updated
08/29/2018
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