Zachary Ellis Blake, PA-C

NPI #1437850674 in Jefferson, Louisiana

Provider Information

NPI Number: 1437850674
Entity Type: Individual
Name: Zachary Ellis Blake, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Mar 14, 2023
Last Updated: Sep 15, 2023

Practice Location

Address: 1514 JEFFERSON HWY
City: Jefferson
State: Louisiana
ZIP Code: 70121-2429
Phone: (504) 842-3000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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