Individual
DR. MICHELLE LYNNE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
309 JACKSON ST, MONROE, LA 71201-7407
(318) 966-4541
(318) 966-4543
Mailing address
1978 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
GETP.LSU-IM
LA
Other
Enumeration date
06/29/2009
Last updated
01/14/2021
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