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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