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NPI Code Detail

MEDICARE: JAMIE YAHYA BLANKENSHIP DO

MEDICARE: JAMIE YAHYA BLANKENSHIP DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician2777WV

General Provider Information

NPI Number : 1235405671
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE YAHYA BLANKENSHIP DO
Provider Business Mailing Address
First Line : 252 RURAL ACRES DR
Second Line :
City : BECKLEY
State : WV
Zip : 25801-3503
Country : US
Telephone Number : 304-253-2628
Fax Number : 304-252-1720
Provider Business Practice Location Address
First Line : 904 HARRISON ST
Second Line :
City : PRINCETON
State : WV
Zip : 24740-3011
Country : US
Telephone Number : 304-431-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2012
Last Update Date : 01/12/2025

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Directions to “ JAMIE YAHYA BLANKENSHIP DO” Practice Location

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