W Kenny Blake MD LLC
NPI #1093011314 in Monticello, Georgia
Provider Information
- NPI Number
- 1093011314
- Entity Type
- Organization
- Organization Name
- W Kenny Blake MD LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Feb 3, 2011
- Last Updated
- Feb 4, 2011
Practice Location
- Address
- 545 VENTURE COURT
- City
- Monticello
- State
- Georgia
- ZIP Code
- 31064
- Phone
- (706) 468-7002
Authorized Official
- Name
- WYATT K BLAKE, MD
- Title
- OWNER
- Phone
- (706) 468-7002
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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