Organization
JEFFREY M. BLAKE MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY M. BLAKE M.D. (OWNER)
(765) 646-8569
Entity
Organization
Contact information
Practice address
141 W. 22ND ST., SUITE 309, ANDERSON, IN 46016-4389
(765) 646-8569
(765) 622-9708
Mailing address
141 W. 22ND ST., SUITE 309, ANDERSON, IN 46016-4389
(765) 646-8569
(765) 622-9708
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IN
Other
Enumeration date
03/27/2007
Last updated
04/27/2011
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