Organization
JON KEVIN BLAKE MD
Active
Other names
Jon K. Blake MD
Organization subpart
No
Provider details
NPI number
Authorized official
JON BLAKE MD (AUTHORIZED OFFICIAL/PHYSICIAN)
(765) 674-7889
Entity
Organization
Contact information
Practice address
925 E MAIN ST, GAS CITY, IN 46933-1550
(765) 674-7889
Mailing address
PO BOX 1889, MUNCIE, IN 47308-1889
(765) 284-0493
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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