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Individual

DR. BRAD E BLANKENSHIP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
306 N CHANCERY ST, MC MINNVILLE, TN 37110-2048
(931) 507-4500
(931) 507-4502
Mailing address
PO BOX 330699, MURFREESBORO, TN 37133-0699
(931) 507-4500
(931) 507-4502

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD17499
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3735031
TN
01
MD17499
MEDICAL LICENSE
TN
Enumeration date
06/12/2006
Last updated
02/08/2008
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