Individual
DENNIS N BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 W JACKSON ST, PIGGOTT, AR 72454-1538
(870) 598-2236
(870) 598-3080
Mailing address
425 W JACKSON ST, PIGGOTT, AR 72454-1538
(870) 598-2236
(870) 598-3080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E2311
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141033001
—
AR
05
—
205038201
—
MO
Enumeration date
08/02/2006
Last updated
03/07/2023
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