Individual
JIM D BLUNK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
415 S OSAGE ST, CALDWELL, KS 67022-1650
(620) 845-2516
(620) 845-2518
Mailing address
5300 N INDEPENDENCE AVE, 280, OKLAHOMA CITY, OK 73112-5556
(620) 845-2516
(620) 845-2518
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-19457
KS
207Q00000X
Family Medicine Physician
2082
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100193490B
—
OK
05
—
100229560B
—
KS
Enumeration date
07/26/2005
Last updated
02/08/2018
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