| Suzzane Marie Blake, MD | |
|
4188 Nw Loop, Carthage, TX 75633-2255 | |
| (903) 315-4160 | |
| (903) 690-0801 |
| Full Name | Suzzane Marie Blake |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 4188 Nw Loop, Carthage, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689698946 | NPI | - | NPPES |
| MD5815 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J9976 (Texas) | Primary |
| Entity Name | Christus Trinity Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285684225 PECOS PAC ID: 3072426741 Enrollment ID: O20031204001091 |
| Entity Name | Mother Frances Hospital Jacksonville |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952306672 PECOS PAC ID: 5597751024 Enrollment ID: O20040421001092 |
| Entity Name | Mother Frances Hospital Regional Health Care Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679578439 PECOS PAC ID: 9234025636 Enrollment ID: O20040610001042 |
| Mailing Address | Practice Location Address |
|---|---|
| Suzzane Marie Blake, MD 4188 Nw Loop, Carthage, TX 75633-2255 Ph: (903) 315-4160 | Suzzane Marie Blake, MD 4188 Nw Loop, Carthage, TX 75633-2255 Ph: (903) 315-4160 |
Dr. Jim Jason Phillips, MD Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 1410 W Panola St, Carthage, TX 75633 Phone: 903-693-9375 Fax: 903-694-4654 | |
Deepti A Govathoti, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 121 Woodmill Ln, Carthage, TX 75633 Phone: 903-693-6626 Fax: 628-246-8409 | |
Louie Royce Hill, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 812 N Daniels St, Carthage, TX 75633 Phone: 903-693-3838 Fax: 903-693-3830 |