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Individual

MR. GEOFFREY M BLANKENSHIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
3075 US ROUTE 60 STE A105, HUNTINGTON, WV 25705-8859
(304) 528-4600
Mailing address
3075 US ROUTE 60, HUNTINGTON, WV 25705-8859
(304) 528-4600

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01162
WV
363A00000X
Physician Assistant
Primary
PA972
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001807775
BLUE CROSS BLUE SHIELD
WV
05
0188020
OH
01
1069705
WORKERS COMPENSATION
WV
05
1841245750
WV
05
7100014080
KY
01
P00372230
RR MEDICARE
WV
Enumeration date
05/23/2006
Last updated
04/23/2025
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