Individual
CHRISTIAN G BLANKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
775 E DOUGLAS ST, PRAIRIE GROVE, AR 72753
(479) 846-5005
(479) 846-5056
Mailing address
PO BOX 1523, FAYETTEVILLE, AR 72702-1523
(479) 571-6038
(479) 582-0222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-2615
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142586001
—
AR
01
—
5L595
AR BC/BS
AR
01
—
P00186080
RR MCR
AR
Enumeration date
06/22/2006
Last updated
12/15/2021
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