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Individual

BLAKE MATHERNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3636 S I 10 SERVICE RD W STE 204, METAIRIE, LA 70001-6418
(504) 218-4936
(504) 218-8241
Mailing address
3636 S I 10 SERVICE RD W STE 204, METAIRIE, LA 70001-6418
(504) 218-4936
(504) 218-8241

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
28777
MS
207W00000X
Ophthalmology Physician
Primary
349073
LA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00772323
MS
Enumeration date
02/21/2018
Last updated
01/27/2026
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