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Individual

DR. DANNY CLAYTON BLANKENSHIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5859 W TALAVI BLVD, SUITE 100, GLENDALE, AZ 85306-1869
(602) 298-7777
(623) 930-6060
Mailing address
5859 W TALAVI BLVD, SUITE 100, GLENDALE, AZ 85306-1869
(602) 298-7777
(623) 930-6060

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35055829
OH
207RI0011X
Interventional Cardiology Physician
Primary
35055829
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000128700
ANTHEM
OH
01
060025257
RAILROAD MEDICARE
05
0946909
OH
01
100403
KAISER
OH
01
341221800041
CARESOURCE
OH
01
E55829
SUMMA
OH
Enumeration date
01/13/2006
Last updated
06/03/2015
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