Blanck, Bryan Andrew
Blanck, Bryan Andrew is an sole proprietor health care provider with primary practice located at 1631 Arlington St , Ada OK 74820-2639. He recently has 5 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Radiology, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Blanck, Bryan Andrew can be contacted via phone (580) 559-0001.Contact Information
Primary practice address
1631 Arlington St
Ada OK 74820-2639
Phone: (580) 559-0001
Fax: (580) 559-0002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | 253 | Oklahoma |
| Podiatric Medicine & Surgery Service Providers / Radiology | 213ER0200X | 253 | Oklahoma |
| Podiatric Medicine & Surgery Service Providers / Sports Medicine | 213ES0000X | 253 | Oklahoma |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | 253 | Oklahoma |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 253 | Oklahoma |
Profile Details
| NPI number | 1215906276 |
|---|---|
| LBN Legal business name | Blanck, Bryan Andrew |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Feb 22nd, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215906276 | NPPES |
| Oklahoma | MEDICAID | 200119690A |
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