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Contact Information

JEFFREY M BLAKE, MD
14540 PRAIRIE LAKES BLVD N STE 110
NOBLESVILLE, IN46060-4370
 Phone: 317-982-5222
 Fax: 317-982-5223
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Urogynecology and Reconstructive Pelvic Surgery

207VF0040X 16 Physician/Obstetrics & Gynecology
 

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for JEFFREY M BLAKE · (Male)

NPI # 1477545127
Status Active
Credentials MD
Entity Individual
Enumeration date 08/18/2005
Last updated 11/14/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 01040057A
  • IN Medicaid 100172960
  • IN Medicaid 300085297
Hospital affiliation(s)
  • COMMUNITY HOSPITAL OF ANDERSON AND MADISON COUNTY - (Acute Care)
    1515 N MADISON AVE
    ANDERSON, IN 46011
  • SAINT JOHN'S HEALTH SYSTEM - (Acute Care)
    2015 JACKSON ST
    ANDERSON, IN 46016
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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