Mr Israel Dennard Blake, is a
Religious Nonmedical Practitioner based in Thomasville, Georgia. Mr Israel Dennard Blake is licensed to practice in Georgia (license number ) and his current practice location is
228 Augusta Ave, Thomasville, Georgia. He can be reached at his office (for appointments etc.) via phone at
(229) 228-7775.
NPI number for Mr Israel Dennard Blake is 1598500605 and his current mailing address is Po Box 2763, Thomasville, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1598500605.
Healthcare Provider's Profile
| Full Name | Mr Israel Dennard Blake |
|---|
| Gender | Male |
|---|
| Speciality | Religious Nonmedical Practitioner |
|---|
| Location | 228 Augusta Ave, Thomasville, Georgia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1598500605
- Provider Enumeration Date: 06/28/2024
- Last Update Date: 06/28/2024
Medical Identifiers
Medical identifiers for Mr Israel Dennard Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1598500605 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YP1600X | Counselor - Pastoral | (Georgia) | Secondary |
| 374K00000X | Religious Nonmedical Practitioner | (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Israel Dennard Blake is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Israel Dennard Blake,
Po Box 2763,
Thomasville, GA 31799-2763
Ph: (229) 228-7775 | Mr Israel Dennard Blake,
228 Augusta Ave,
Thomasville, GA 31792-7003
Ph: (229) 228-7775 |
Reviews and Comments