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Individual

DR. KENT JAMES BLANKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1408 CROWN DRIVE, KIRKSVILLE, MO 63501
(660) 665-1100
(660) 665-3440
Mailing address
PO BOX 7547, KIRKSVILLE, MO 63501
(660) 665-1100
(660) 665-3440

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
106501
MO
2086S0129X
Vascular Surgery Physician
5101010137
MI

Other

Enumeration date
11/29/2006
Last updated
07/08/2007
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