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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760779458 NPPES
Ohio MEDICAID 0292533

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