Individual
DR. BLAKE NORTON GEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7901 DALLAS ST, FORT SMITH, AR 72903-4281
(479) 782-8892
(479) 782-8840
Mailing address
7901 DALLAS ST, FORT SMITH, AR 72903-4281
(479) 782-8892
(479) 782-8840
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
E5157
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164798001
—
AR
05
—
200115630A
—
OK
01
—
CQ2484
RAILROAD MEDICARE
—
01
—
P00419389
RAILROAD MEDICARE
AR
Enumeration date
06/25/2006
Last updated
12/17/2019
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