Blake, Jonathan E.

Blake, Jonathan E. is an individual health care provider with primary practice located at 1401 Hwy 65 North Suite 210 , Harrison AR 72601. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Blake, Jonathan E. can be contacted via phone (870) 414-5600.

Contact Information

Primary practice address
1401 Hwy 65 North Suite 210 Harrison AR 72601
Phone: (870) 414-5600
Fax: (870) 414-5601
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 133417 Illinois
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 7833 South Dakota
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X T3745 Texas

Profile Details

NPI number 1598739708
LBN Legal business name Blake, Jonathan E.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Aug 11th, 2023 - 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 1598739708 NPPES
Missouri MEDICAID 244982104
Missouri MEDICAID 6400000

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