Individual
DR. HU AL BLAKE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
199 S CANDY LN, SUITE 1A, COTTONWOOD, AZ 86326-4183
(928) 649-7969
(928) 634-7921
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 773-2559
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
29975
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
636128
—
AZ
Enumeration date
04/03/2006
Last updated
03/14/2017
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