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Individual

DR. JOE HARRY BLANKSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1700 AVENUE E, BIRMINGHAM, AL 35218-1543
(205) 788-3321
(205) 241-5260
Mailing address
1700 AVENUE E, BIRMINGHAM, AL 35218-1543
(205) 788-3321
(205) 241-5260

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00011655
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051036526
BLUE CROSS BLUE SHIELD
AL
01
1508844184
NPI
01
1942235825
MEDICARE GROUP PAYEE NPI
AL
05
303739314
AL
01
D074
MEDICARE GROUP NUMBER
AL
Enumeration date
01/04/2006
Last updated
03/02/2010
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