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Individual

DR. JOHN PAUL BLAKE I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
211 S CENTENNIAL ST, HIGH POINT, NC 27260-5215
(336) 845-7946
(336) 845-7601
Mailing address
211 S CENTENNIAL ST, HIGH POINT, NC 27260-5215
(336) 845-7946
(336) 845-7601

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
11795
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8916172
NC
Enumeration date
12/13/2006
Last updated
06/10/2009
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