Jacob Robert Blank, DO
in Scottsdale, AZ. Individual provider (NPI-1).
NPI number1619618907
StatusActive
Last updated in NPPESSep 22, 2026
Details
- NPI
- 1619618907
- Entity type
- Individual (NPI-1)
- Name
- Jacob Robert Blank
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 2, 2022
- Certification date
- Sep 22, 2026
- Last updated
- Sep 22, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208VP0000X | 012300 | AZ | Yes |
Practice location
13400 E Shea BlvdScottsdale, AZ 85259-5404
Phone 480-301-8000
Mailing address
Po Box 860912Minneapolis, MN 55486-0912
Fax 512-628-3314
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