Gregory W Blank, PA

Individual provider Active NPI Physician Assistant · Mason City, IA

NPI 1831161736 · NPPES record last updated Feb 17, 2009

Key facts

NPI
1831161736
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
001629 (IA)
Practice address
250 S Crescent Dr
Mason City, IA 50401-2926
Phone
(641) 422-6730
Fax
(641) 422-6659
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central States Medicine, PLLC Past Accepting new patients
Prairie Cardiovascular Consultants LTD Past
since Sep 20, 2010
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001629 IA Yes

Addresses

Primary practice location

250 S Crescent Dr
Mason City, IA 50401-2926

Mailing address

250 S Crescent Dr
Mason City, IA 50401-2926
Phone (641) 422-6730

Other providers in Mason City, IA

All providers in Mason City, IA · Physician Assistant in Iowa

Sources for this page

Verify at the official NPI Registry.