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Individual

CASI BLANTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
635 BARNHILL DR BLDG 116, INDIANAPOLIS, IN 46202-5126
(317) 274-0076
Mailing address
1200 CHARLTON CT, DANVILLE, IN 46122-7825

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11022342A
IN
390200000X
Student in an Organized Health Care Education/Training Program
86268
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1669828166
NC
Enumeration date
05/13/2016
Last updated
06/15/2022
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