Provider Demographics
NPI:1245202274
Name:BLANKENSHIP, JAMES BLAIR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BLAIR
Last Name:BLANKENSHIP
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2793 E MILLENNIUM
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-6522
Mailing Address - Country:US
Mailing Address - Phone:479-582-9025
Mailing Address - Fax:479-582-1572
Practice Address - Street 1:2793 E MILLENNIUM
Practice Address - Street 2:SUITE 1
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-6522
Practice Address - Country:US
Practice Address - Phone:479-582-9025
Practice Address - Fax:479-582-1572
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2014-11-12
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Provider Licenses
StateLicense IDTaxonomies
ARC7058207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR112777001Medicaid
AR5121740001Medicare NSC
AR50974Medicare PIN
AR112777001Medicaid
AR50947Medicare PIN