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Contact Information

JACOB L BLAKE, MD
5590 KIETZKE LN
RENO, NV89511-3019
 Phone: 775-323-2080
 Fax: 775-683-9404
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for JACOB L BLAKE · (Male)

NPI Number 1154486769
Status Active
Credentials MD
Entity Individual
Enumeration date 12/26/2006
Last updated 01/29/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • CA License # A95206
  • NV License # 14407
  • WA License # MD60071790
Hospital affiliation(s)
  • RENOWN REGIONAL MEDICAL CENTER - (Acute Care)
    1155 MILL STREET
    RENO, NV 89502
  • RENOWN SOUTH MEADOWS MEDICAL CENTER - (Acute Care)
    10101 DOUBLE R BLVD
    RENO, NV 89521
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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