Smith, Blake Robert
Smith, Blake Robert is an sole proprietor health care provider with primary practice located at 3650 Steve Reynolds Blvd Dept Of , Duluth GA 30096-4506. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Smith, Blake Robert can be contacted via phone (404) 365-0966.Contact Information
Primary practice address
3650 Steve Reynolds Blvd Dept Of
Duluth GA 30096-4506
Phone: (404) 365-0966
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 079904 | Georgia |
Profile Details
NPI number | 1780927269 |
---|---|
LBN Legal business name | Smith, Blake Robert |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Apr 3rd, 2013 |
Last updated | Jan 17th, 2019 - about 5 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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