Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BLAKE JEFFREY ILLSTON, D.O.
Active Sole ProprietorDR. BLAKE JEFFREY ILLSTON, D.O. is a Emergency Medicine healthcare provider located in FORT GORDON, Georgia. NPI 1487876355 is currently active in the NPPES registry. Verify at CMS.
Emergency Medicine · FORT GORDON, GA
Registration Details
- NPI Number
- 1487876355
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 2, 2007 (19.276223867181 yrs)
- Last Updated
- Mar 29, 2023
- Licenses
-
RTP001882 (GA)68035 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
300 W HOSPITAL RDFORT GORDON, GA, 309055741Browse GA providers · Browse ZIP 30905
- Phone
- 7067879285
- Primary Specialty
-
Emergency Medicine
207P00000X
- Additional Specialty
- Emergency Medicine
Other Emergency Medicine Providers in FORT GORDON, GA
| Name | Credential | NPI |
|---|---|---|
| DR. STEVEN JAMES CURRIER | MD | 1437129541 |
| DR. THOMAS LEE ZICKGRAF | D.O. | 1760455455 |
| DR. JACQUES R PYE | MD | 1770524134 |
| STEVEN TIERNAN | MD | 1811923725 |
| ROLANDO TORRES | MD | 1528097003 |
| BRETT A BECKMAN | MD | 1629161575 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.