Individual
DR. DANIEL R BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 MANCHESTER EXPY, STE C003, COLUMBUS, GA 31904-6802
(706) 324-7753
(706) 324-7756
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
052686
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114083
—
AL
01
—
511I040035
MEDICARE PTAN
GA
05
—
710405327
—
GA
Enumeration date
05/11/2006
Last updated
06/04/2020
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