Organization
BLANKENSHIP MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD E BLANKENSHIP MD (OWNER)
(615) 796-0902
Entity
Organization
Contact information
Practice address
306 N CHANCERY ST, MC MINNVILLE, TN 37110-8904
(931) 507-4500
(931) 507-4502
Mailing address
PO BOX 330699, MURFREESBORO, TN 37133-0699
(931) 507-4500
(931) 507-4502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD17499
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3735031
—
TN
Enumeration date
07/25/2006
Last updated
02/08/2008
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