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Contact Information

SUSAN F BLAKE, OD
2216 LINCOLN WAY E
MASSILLON, OH44646-7062
 Phone: 330-832-9966
 Fax: 330-832-6007
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for SUSAN F BLAKE · (Female)

NPI Number 1811963705
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 02/28/2006
Last updated 08/02/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 5196
  • OH Medicaid 2601081
  • OH Other 51108 DAVIS VISION
  • OH Other OH5196 EYEMED
  • OH Other 22683 NVA
  • OH Other 311529091 PCM
  • OH Other 27426 SPECTERA
  • OH Other 202699359 TRICARE
  • OH Other 311529091 UNITED HEALTH CARE
  • OH Other OH00213 VBA
  • OH Other 202699359 VSP
Hospital affiliation(s) Not Available
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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