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Contact Information

BRYAN A BLANCK, DPM
1631 ARLINGTON ST
ADA, OK74820-2639
 Phone: 580-559-0001
 Fax: 580-559-0002
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Primary Podiatric Medicine

213EP1101X 48 Podiatry
 

Radiology

213ER0200X 48 Podiatry
 

Sports Medicine

213ES0000X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BRYAN A BLANCK · (Male)

NPI Number 1215906276
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 03/14/2006
Last updated 02/22/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • OK License # 253
  • OK Medicaid 200119690A
Hospital affiliation(s)
  • ARBUCKLE MEMORIAL HOSPITAL - (Critical Access)
    2011 WEST BROADWAY
    SULPHUR, OK 73086
  • INTEGRIS SEMINOLE MEDICAL CENTER - (Acute Care)
    2401 WRANGLER BOULEVARD
    SEMINOLE, OK 74868
  • VALLEY VIEW REGIONAL HOSPITAL - (Acute Care)
    430 NORTH MONTA VISTA
    ADA, OK 74820
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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