Organization
MEDNORTH GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH DAVID BLANKENSHIP MD (OWNER AND PRESIDENT)
(731) 664-5150
Entity
Organization
Contact information
Practice address
3000 GREYSTONE SQ, JACKSON, TN 38305-3589
(731) 664-5150
(731) 664-5059
Mailing address
3000 GREYSTONE SQ, JACKSON, TN 38305-3589
(731) 664-5150
(731) 664-5059
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1430
TLC
TN
01
—
165539
UNISON HEALTH PLAN
TN
05
—
3729018
—
TN
01
—
4102813
BCBST
TN
Enumeration date
04/21/2006
Last updated
02/23/2012
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