Individual
MR. JOHN VAYDEN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
315 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-1086
(304) 469-2905
(304) 465-5486
Mailing address
497 MALL RD, OAK HILL, WV 25901-6216
(304) 469-2905
(304) 465-5486
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
202
WV
363A00000X
Physician Assistant
Primary
929
WV
Other
Enumeration date
12/30/2005
Last updated
01/03/2025
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