Individual
EMMITT MATTHEW BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1325 EASTMORELAND AVE STE 365, MEMPHIS, TN 38104-7542
(901) 272-6030
(901) 516-8450
Mailing address
P O BOX 1000 DEPT 960, MEMPHIS, TN 38148-0001
(901) 763-0200
(901) 260-1704
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3404
TN
363A00000X
Physician Assistant
C06210
MD
Other
Enumeration date
06/06/2016
Last updated
12/14/2017
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