Individual
JOE GLENN BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101035540
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
065693
ANTHEM BCBS
VA
01
—
1127411
UMWA
VA
01
—
268204
SOUTHERN HEALTH
VA
Enumeration date
04/06/2006
Last updated
10/25/2007
Update your record
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