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Individual

DR. JOE DAVID BLANKENSHIP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3000 GREYSTONE SQ, JACKSON, TN 38305-3589
(731) 664-5150
(731) 664-5059
Mailing address
3000 GREYSTONE SQ, JACKSON, TN 38305-3589
(731) 664-5150
(731) 664-5059

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11096
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
165546
UNISON HEALTH PLAN
TN
05
3842457
TN
01
4102818
BCBST
TN
01
7030
TLC
TN
Enumeration date
04/25/2006
Last updated
03/28/2023
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