Individual
MATT MOREY BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10507 E 91ST ST, 270, TULSA, OK 74133-5589
(918) 307-5480
(918) 307-5481
Mailing address
PO BOX 305, LOWELL, AR 72745-0305
(918) 481-4706
(918) 481-4765
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
22457
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200112540A
—
OK
Enumeration date
01/23/2007
Last updated
03/29/2016
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