Individual
TIMOTHY BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2006018048
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0814870002
MEDICARE NSC NUMBER
MO
01
—
0814870015
MEDICARE NSC NUMBER
MO
01
—
0814870017
MEDICARE NSC NUMBER
MO
01
—
127205
HEALTH ALLIANCE
—
01
—
211780
ANTHEM BLUE CROSS BLUE SHIELD
MO
05
—
310865506
—
MO
01
—
MO8048
EYEMED
—
01
—
P00434357
MEDICARE RAILROAD
MO
Enumeration date
07/17/2006
Last updated
10/01/2008
Update your record
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