Blake Richard Shaffer, MD is a
Student In An Organized Health Care Education/training Program physician based in Eglin Afb, Florida. Blake Richard Shaffer is licensed to practice in Virginia (license number 0101261224) and his current practice location is 307 Boatner Rd Ste 114, Eglin Afb, Florida. He can be reached at his office (for appointments etc.) via phone at
(850) 883-8600.
NPI number for Blake Richard Shaffer is 1235510140 and his current mailing address is 307 Boatner Rd Ste 114, Eglin Afb, Florida. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1235510140.
Physician's Profile
Full Name | Blake Richard Shaffer |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 307 Boatner Rd Ste 114, Eglin Afb, Florida |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1235510140
- Provider Enumeration Date: 06/16/2015
- Last Update Date: 06/05/2020
Medical Identifiers
Medical identifiers for Blake Richard Shaffer such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1235510140 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | MT208977 (Pennsylvania) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 0101261224 (Virginia) | 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. Blake Richard Shaffer 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 |
Blake Richard Shaffer, MD 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 Ph: () - | Blake Richard Shaffer, MD 307 Boatner Rd Ste 114, Eglin Afb, FL 32542-1302 Ph: (850) 883-8600 |
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