Individual
JONATHAN BLANDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3346 PROFESSIONAL PARK, OWENSBORO, KY 42303-4551
(270) 852-8934
(270) 852-8924
Mailing address
3346 PROFESSIONAL PARK, OWENSBORO, KY 42303-4551
(270) 852-8934
(270) 852-8924
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04539
KY
390200000X
Student in an Organized Health Care Education/Training Program
218763
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300029986
—
IN
05
—
7100604950
—
KY
Enumeration date
06/08/2016
Last updated
03/14/2022
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