Individual
JOHN R BLAKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4306 ASHEVILLE HWY, KNOXVILLE, TN 37914-3601
(865) 522-2168
(865) 522-7116
Mailing address
4306 ASHEVILLE HWY, KNOXVILLE, TN 37914-3601
(865) 522-2168
(865) 522-7116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD16391
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3721704
—
TN
Enumeration date
01/24/2006
Last updated
02/03/2014
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