Anderson, Blake L
Anderson, Blake L is an individual health care provider with primary practice located at 9001 S 101St East Ave Ste 280 , Tulsa OK 74133-5711. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Anderson, Blake L can be contacted via phone (918) 459-8824.Contact Information
Primary practice address
9001 S 101St East Ave Ste 280
Tulsa OK 74133-5711
Phone: (918) 459-8824
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | L6260 | Texas |
Profile Details
| NPI number | 1962499574 |
|---|---|
| LBN Legal business name | Anderson, Blake L |
| Credentials | MD PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2005 |
| Last updated | Jan 12th, 2021 - 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 | 1962499574 | NPPES |
| Texas | Other | 1459097 | BEECHSTREET |
| Texas | MEDICAID | 157856901 | BEECHSTREET |
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