Blake Surgical Association Pllc
LBN: Blake Surgical Association Pllc
Blake Surgical Association Pllc is an health care organization with primary practice located at 907 E Sunflower Rd #101 , Cleveland MS 38732-2833. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgical Critical Care is the primary health care specialty.
Blake Surgical Association Pllc can be contacted via phone (662) 846-8880, or through Blake, Roger via phone (662) 846-8880.
Contact Information
Primary practice address
907 E Sunflower Rd #101
Cleveland MS 38732-2833
Phone: (662) 846-8880
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 16881 | Mississippi |
| Allopathic & Osteopathic Physicians / Surgical Critical Care | 2086S0102X | 16881 | Mississippi |
Profile Details
| NPI number | 1154521466 |
|---|---|
| LBN Legal business name | Blake Surgical Association Pllc |
| DBA Doing business as | |
| Authorized official | Blake, Roger Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 24th, 2007 |
| Last updated | Aug 30th, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154521466 | NPPES |
| Mississippi | Other | 020000545 | MEDICARE PROVIDER # |
| Mississippi | Other | C03406 | MEDICARE PROVIDER # |
| Mississippi | MEDICAID | 00122620 | MEDICARE PROVIDER # |
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