Lilly, Dale Blake

Lilly, Dale Blake is an sole proprietor health care provider with primary practice located at 2823 3Rd Ave , Huntington WV 25702-1423. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Lilly, Dale Blake can be contacted via phone (304) 523-3937.

Contact Information

Primary practice address
2823 3Rd Ave Huntington WV 25702-1423
Phone: (304) 523-3937
Fax: (304) 523-3945
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 17041 West Virginia

Profile Details

NPI number 1376557918
LBN Legal business name Lilly, Dale Blake
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2006
Last updated Apr 4th, 2013 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376557918 NPPES
West Virginia Other 17041 WV STATE
West Virginia MEDICAID 0096101000 WV STATE
West Virginia MEDICAID 0219534 WV STATE

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