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Individual

BLAKE V FAUSETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
2550 WILLAKENZIE RD, EUGENE, OR 97401-7865
(541) 434-0922
(541) 434-4369
Mailing address
2550 WILLAKENZIE RD, EUGENE, OR 97401-7865
(541) 434-0922

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01073972A
IN
207W00000X
Ophthalmology Physician
35123349
OH
207W00000X
Ophthalmology Physician
TP636
KY
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
MD175770
OR

Other

Enumeration date
07/07/2009
Last updated
04/25/2025
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