Individual
MR. WALTER DAVID BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
9135 MIDDLEBROOK PIKE, KNOXVILLE, TN 37923-1425
(865) 558-3038
Mailing address
6933 LARK LN, KNOXVILLE, TN 37919-5929
(865) 776-0800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1171
TN
363A00000X
Physician Assistant
MB1192183
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4099853
BLUE CROSS
TN
01
—
P00232697
RAILROAD MEDICARE
TN
Enumeration date
06/07/2006
Last updated
02/14/2023
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