Olmsted, Blake
Olmsted, Blake is an individual health care provider with primary practice located at 6414 U S Highway 98 Ste 80 , Hattiesburg MS 39402-7838. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy & Immunology, which is considered as his primary health care specialty. Olmsted, Blake can be contacted via phone (601) 261-1800.Contact Information
Primary practice address
6414 U S Highway 98 Ste 80
Hattiesburg MS 39402-7838
Phone: (601) 261-1800
Fax: (601) 261-1801
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Allergy & Immunology | 207K00000X | 23912 | Mississippi |
Profile Details
| NPI number | 1780948216 |
|---|---|
| LBN Legal business name | Olmsted, Blake |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 29th, 2012 |
| Last updated | Aug 11th, 2020 - about 4 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 | 1780948216 | NPPES |
| Mississippi | MEDICAID | 05583609 |
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