Organization
BLANKENSHIP INTERNAL MEDICINE, L.L.C.
Active
Organization
BLANKENSHIP INTERNAL MEDICINE, L.L.C.
Active
Other names
Harold Blankenship, D.O., F.A.C.O.I.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAROLD BLANKENSHIP D.O. (MEMBER/OWNER)
(417) 782-2125
Entity
Organization
Contact information
Practice address
1905 W 32ND ST, STE. 407, JOPLIN, MO 64804-1529
(417) 782-2125
(417) 782-2145
Mailing address
1905 W 32ND ST, STE. 407, JOPLIN, MO 64804-1529
(417) 782-2125
(417) 782-2145
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2005009945
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100183010A
—
OK
01
—
197311
ANTHEM
—
05
—
200312050A
—
KS
05
—
207291402
—
MO
01
—
P00215074
RR MEDICARE
—
Enumeration date
07/10/2009
Last updated
07/10/2009
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