Blake, Kendall T
Blake, Kendall T is an individual health care provider with primary practice located at 2500 N State St Dept Of Orthopedics, Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, which is considered as his primary health care specialty. Blake, Kendall T can be contacted via phone (601) 984-6525.Contact Information
Primary practice address
2500 N State St Dept Of Orthopedics
Jackson MS 39216-4500
Phone: (601) 984-6525
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | 06797 | Mississippi |
Profile Details
| NPI number | 1427072966 |
|---|---|
| LBN Legal business name | Blake, Kendall T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 27th, 2006 |
| Last updated | Mar 7th, 2014 - about 11 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 | 1427072966 | NPPES |
| Mississippi | MEDICAID | 00116141 |
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