Individual
BLAKE ANDRE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2854 BELL ST, ZANESVILLE, OH 43701-1721
(740) 454-3273
(740) 588-1081
Mailing address
2854 BELL ST, ZANESVILLE, OH 43701-1721
(740) 454-3273
(740) 588-1081
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
50.004031
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101439
—
OH
Enumeration date
03/20/2014
Last updated
08/31/2016
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