Individual
DR. GREGORY HAROLD BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
1924 ALCOA HWY, U-100, KNOXVILLE, TN 37920-1511
(865) 544-9351
(865) 544-9314
Mailing address
1924 ALCOA HWY, U-67, KNOXVILLE, TN 37920-1511
(865) 544-9352
(865) 544-9314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26558
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-41085
UNITED HEATLH CARE
TN
01
—
080100419
RAILROAD MEDICARE
—
01
—
100011282
PHP TENNCARE
TN
01
—
1689631137
GROUP NPI
TN
01
—
3023731
BLUE CROSS/BLUE SHIELD
TN
05
—
3092066
—
TN
01
—
3523237
CIGNA
TN
01
—
5766020
AETNA
TN
01
—
TN0191
JOHN DEERE
TN
Enumeration date
04/27/2006
Last updated
09/28/2012
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