BLAKE ROBERT SMITH (NPI# 1780927269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780927269 |
| Entity Type | Individual |
| Full Name | BLAKE ROBERT SMITH |
| Credential | MD |
| Practice Address |
3650 Steve Reynolds Blvd Dept Of Duluth GA 30096-4506 |
| Mailing Address |
9500 Euclid Ave Head and Neck Institute, Cleveland Clinic Cleveland OH 44195-0001 |
| Practice Telephone | 4043650966 |
| Mailing Telephone | 2164444949 |
| Mailing Fax Number | 2166361548 |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2019-01-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 079904 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9500 Euclid Ave, Head and Neck Institute, Cleveland Clinic, Cleveland, OH 441950001 | 2164444949 | 2166361548 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952591398 | Blake E Smith | Optometrist | 4612 S Coulter St, Amarillo, TX 79119-6403 | 2007-08-01 |
| 1649839317 | Blake Edward Smith | Counselor | 10564 Se Washington St, Portland, OR 97216-2809 | 2019-06-06 |
| 1275089609 | Blake Smith | Specialist | 2630 W Rumble Rd, Modesto, CA 95350-0155 | 2016-08-26 |
| 1639547904 | Blake Eric Smith | Occupational Therapy Assistant | 169 Valentine Rd, Pittsfield, MA 01201-3042 | 2015-09-03 |
| 1770979221 | Blake Gaither Smith | Student in an Organized Health Care Education/Training Program | 625 19th Street South, Birmingham, AL 35249 | 2015-04-11 |
| 1093132631 | Blake Andre Smith | Physician Assistant | 2854 Bell St, Zanesville, OH 43701-1721 | 2014-03-20 |
| 1881031946 | Blake Daniel Smith | Dentist | 2600 Bemidji Ave N, Bemidji, MN 56601-2324 | 2013-05-30 |
| 1760718282 | Blake Smith | Registered Nurse | 80 Enoch Blvd, Savannah, TN 38372 | 2009-10-19 |
| 1518192533 | Blake Allen Smith | Psychiatry & Neurology | 4805 Montgomery Rd, Suite 410, Cincinnati, OH 45212-2198 | 2009-05-19 |
| 1760512966 | Blake Andrew Smith | Emergency Medicine | 1301 Punchbowl St, Honolulu, HI 96813-2402 | 2007-03-06 |
| Street Address |
3650 STEVE REYNOLDS BLVD DEPT OF |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-4506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396726659 | Northland Ear, Nose & Throat Associates, P.a. | Otolaryngology | 920 E 1st Street, Suite 301, Duluth, MN 55805 | 2005-11-11 |
| 1609857101 | David M Choquette | Otolaryngology | 920 E 1st St, Suite 301, Duluth, MN 55805-2201 | 2005-11-10 |
| 1013915586 | Michael John Pickford | Otolaryngology | 3855 Pleasant Hill Rd, Suite 280, Duluth, GA 30096-1407 | 2005-07-08 |
| 1649275751 | Christopher J Lee | Otolaryngology | 3500 Duluth Park Ln, Suite 210, Duluth, GA 30096-3242 | 2005-06-15 |
| 1033653209 | St. Luke's Hospital of Duluth | Otolaryngology | 920 E 1st St, Ste. 301, Duluth, MN 55805-2225 | 2016-12-07 |
| 1639582273 | Heidi Elaine L'esperance | Otolaryngology | 400 E 3rd St, Duluth, MN 55805-1951 | 2014-06-10 |
| 1659794691 | Gwinnett Ear Nose & Throat, LLC | Otolaryngology | 3855 Pleasant Hill Rd, Suite 280, Duluth, GA 30096-1407 | 2014-01-28 |
| 1366622573 | Christopher J. Lee Md, P.C. | Otolaryngology | 3500 Duluth Park Ln, Suite 210, Duluth, GA 30096-3242 | 2007-11-06 |
| 1598983371 | Jonathan Shane Glickstein | Otolaryngology | 400 E 3rd St, Duluth, MN 55805-1951 | 2007-04-24 |
| 1346375151 | Rolando R Rosas | Otolaryngology | 400 E 3rd St, Essentia Health Duluth Clinic, Duluth, MN 55805-1951 | 2007-02-22 |
| Find all providers in DULUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.