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Individual

RICHARD STANFILL BLANKENBAKER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
407 S SCHWARTZ AVE STE 202, FARMINGTON, NM 87401-5925
(505) 609-6770
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
G76312
CA
207RI0011X
Interventional Cardiology Physician
Primary
MD2023-1626
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010884465
CA
Enumeration date
09/12/2006
Last updated
12/12/2025
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