Individual
DR. BENJAMIN JAY BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5016 S US HIGHWAY 75, DENISON, TX 75020-4584
(903) 416-2435
Mailing address
536 CARRIAGE ESTATES RD, SHERMAN, TX 75092-4444
(940) 594-8560
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
P5037
TX
Other
Enumeration date
06/23/2011
Last updated
07/18/2014
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