Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. WYATT KENNY BLAKE, MD
ActiveDR. WYATT KENNY BLAKE, MD is a Family Medicine healthcare provider located in GRAY, Georgia. NPI 1548263064 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · GRAY, GA
Registration Details
- NPI Number
- 1548263064
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 30, 2005 (21.023890551721 yrs)
- Last Updated
- Jul 17, 2019
- License
-
047702 (GA)
Practice Information
- Address
-
1005 BOULDER DRGRAY, GA, 31032Browse GA providers · Browse ZIP 31032
- Phone
- 4786212100
- Fax
- 4787440481
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in GRAY, GA
| Name | Credential | NPI |
|---|---|---|
| MRS. LINDA S ARNOLD | MD | 1194710293 |
| DR. RALPH PARKS WARNOCK | M.D. | 1942295712 |
| DR. ROBERT DAVID CAMPBELL | M.D. | 1609843812 |
| MEREDI A ANDERS | PAC | 1477560555 |
| DR. MELISSA D PRIMROSE | M.D. | 1457496234 |
| BOLIVIA TRACI JENKINS | MD | 1275111304 |
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.