Huddleston, Blake

Huddleston, Blake is an individual health care provider with primary practice located at 340 N Cedar Ave , Cookeville TN 38501-2421. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Huddleston, Blake can be contacted via phone (931) 783-5353.

Contact Information

Primary practice address
340 N Cedar Ave Cookeville TN 38501-2421
Phone: (931) 783-5353
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 3389 Tennessee

Profile Details

NPI number 1700302171
LBN Legal business name Huddleston, Blake
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2017
Last updated Oct 25th, 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 1700302171 NPPES
Tennessee MEDICAID Q031971

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