Blake, Jeffrey M

Blake, Jeffrey M is an sole proprietor health care provider with primary practice located at 14540 Prairie Lakes Blvd N Ste 110 , Noblesville IN 46060-4370. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is his primary health care specialty. Blake, Jeffrey M can be contacted via phone (317) 982-5222.

Contact Information

Primary practice address
14540 Prairie Lakes Blvd N Ste 110 Noblesville IN 46060-4370
Phone: (317) 982-5222
Fax: (317) 982-5223
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 01040057A Indiana
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X 01040057A Indiana

Profile Details

NPI number 1477545127
LBN Legal business name Blake, Jeffrey M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2005
Last updated Apr 25th, 2024 - about last year

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 1477545127 NPPES
Indiana MEDICAID 300085297
Indiana MEDICAID 100172960

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