Anderson, Blake Bailey
Anderson, Blake Bailey is an individual health care provider with primary practice located at 2350 Miami Valley Dr Ste 500 , Centerville OH 45459-4780. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is his primary health care specialty. Anderson, Blake Bailey can be contacted via phone (937) 293-1622.Contact Information
Primary practice address
2350 Miami Valley Dr Ste 500
Centerville OH 45459-4780
Phone: (937) 293-1622
Fax: (937) 245-6308
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 125.059643 | Illinois |
Allopathic & Osteopathic Physicians / Urology | 208800000X | 01078386A | Indiana |
Allopathic & Osteopathic Physicians / Urology | 208800000X | 35133214 | Ohio |
Profile Details
NPI number | 1760779458 |
---|---|
LBN Legal business name | Anderson, Blake Bailey |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 1st, 2011 |
Last updated | Jan 7th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1760779458 | NPPES |
Ohio | MEDICAID | 0292533 |
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