# JACOB BLAKE, MD LTD.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sierra Peak Pain Management
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154839637
- **Authorized official:** MRS. KENDALL QUINLAN (CREDENTIALING)
- **Authorized official phone:** (775) 720-1573

## Contact information

- **Practice address:** 5590 KIETZKE LANE, RENO, NV 89511
- **Practice address phone:** (775) 323-2080
- **Practice address fax:** (775) 323-8216
- **Mailing address:** 5590 KIETZKE LN, RENO, NV 89511-3019
- **Mailing address phone:** (775) 323-2080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 11407 | NV | Yes |

## Other

- **Enumeration date:** 01/18/2018
- **Last updated:** 06/16/2018