Individual
JEFFREY A BLINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD STE 230, GREEN BAY, WI 54311-6519
(920) 288-8250
(920) 288-8255
Mailing address
164 N BROADWAY, PO BOX 8900, GREEN BAY, WI 54303-2728
(920) 288-8250
(920) 288-8255
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
30107
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104358337
—
MI
05
—
104470257
—
MI
05
—
31473700
—
WI
01
—
770001953
RAILROAD
WI
Enumeration date
06/28/2006
Last updated
01/11/2016
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