Provider Demographics
NPI:1902948441
Name:BLANKSON, VICTOR N (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:N
Last Name:BLANKSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:303 CARLISLE DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19311-1440
Mailing Address - Country:US
Mailing Address - Phone:610-268-2696
Mailing Address - Fax:502-508-4696
Practice Address - Street 1:303 CARLISLE DR
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:PA
Practice Address - Zip Code:19311-1440
Practice Address - Country:US
Practice Address - Phone:610-268-2696
Practice Address - Fax:502-508-4696
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY351542080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine