| Jon Kevin Blake Md | |
|
925 E Main St Gas City IN 46933-1550 | |
| (765) 674-7889 | |
| Not Available |
| Full Name | Jon Kevin Blake Md |
|---|---|
| Speciality | General Practice |
| Location | 925 E Main St, Gas City, Indiana |
| Authorized Official Name and Position | Jon Blake (AUTHORIZED OFFICIAL/PHYSICIAN) |
| Authorized Official Contact | 7656747889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jon Kevin Blake Md Po Box 1889 Muncie IN 47308-1889 Ph: (765) 284-0493 | Jon Kevin Blake Md 925 E Main St Gas City IN 46933-1550 Ph: (765) 674-7889 |
| NPI Number | 1215559331 |
|---|---|
| Provider Enumeration Date | 05/12/2020 |
| Last Update Date | 05/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215559331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
Mississinewa Medical Center, Dr. Lori Fuqua Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 717 E Main St, Gas City, IN 46933 Phone: 765-677-4719 Fax: 765-677-4727 |