Provider Demographics
NPI:1427042621
Name:BLANFORD, ARTHUR T (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:T
Last Name:BLANFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 950248
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0248
Mailing Address - Country:US
Mailing Address - Phone:502-238-2801
Mailing Address - Fax:502-238-2835
Practice Address - Street 1:4000 KRESGE WAY
Practice Address - Street 2:SUITE 228
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207
Practice Address - Country:US
Practice Address - Phone:502-893-5100
Practice Address - Fax:502-893-8408
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20145207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000535314OtherANTHEM
KY64201452Medicaid
KYC70741Medicare UPIN
KY00162044Medicare PIN
KY64201452Medicaid