Whalio Doctors

NPI 1164440368

Timothy Blankenship, OD

Practitioner Optometrist Poplar Bluff, MO

Practice location

Address
2511 N Westwood Blvd, Poplar Bluff, MO 63901-2338
Phone
(573) 686-5866
Fax
(573) 686-0425
Mailing address
1200 W Deyoung St, Marion, IL 62959-4437

Registered specialties

Optometrist Primary
Eye and Vision Services Providers Taxonomy 152W00000X Licence 2006018048 (MO)

Registry record

NPI
1164440368
Entity type
Individual
Sex (as registered)
Male
NPI issued
17 Jul 2006
Record last updated
1 Oct 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.