BLAKE SURGICAL ASSOCIATION PLLC NPI 1154521466

NPI Information

  • NPI: 1154521466
  • Provider Name: BLAKE SURGICAL ASSOCIATION PLLC
  • Classification: Surgery - 2086S0102X
  • Specialization: Surgical Critical Care
  • Entity Type: Organization
  • Address: 907 E SUNFLOWER RD #101
    CLEVELAND, MS
    ZIP 38732
  • Phone: (662) 846-8880

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NPI Details

BLAKE SURGICAL ASSOCIATION PLLC is a surgical critical care surgery in Cleveland, MS. The provider is a surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. BLAKE SURGICAL ASSOCIATION PLLC NPI is 1154521466. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

907 E SUNFLOWER RD #101
CLEVELAND, MS
ZIP 38732-833
Phone: (662) 846-8880

The provider's authorized official is Roger Blake .
The authorized official title is Owner/physician and has the following contact phone number (662) 846-8880.

The enumeration date for this NPI number is 7/24/2007 and was last updated on 8/30/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgery16881MISSISSIPPINo
22086S0102XSurgerySurgical Critical Care16881MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1C03406OTHERMISSISSIPPIMEDICARE GROUP #
200122620MEDICAIDMISSISSIPPI
3020000545OTHERMISSISSIPPIMEDICARE PROVIDER #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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