Provider Demographics
NPI:1538921648
Name:BLANKENSHIP, ARNIE JEROME
Entity type:Individual
Prefix:MR
First Name:ARNIE
Middle Name:JEROME
Last Name:BLANKENSHIP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:578 NE 2ND ST APT A
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74525-4707
Mailing Address - Country:US
Mailing Address - Phone:580-239-8375
Mailing Address - Fax:
Practice Address - Street 1:578 NE 2ND ST APT A
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-4707
Practice Address - Country:US
Practice Address - Phone:580-239-8375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management