| Blake Randall Ridgway, CRNA | |
| 
					1800 W University Blvd, Durant, OK 74701-3006  | |
| (281) 249-5954 | |
| Not Available | 
| Full Name | Blake Randall Ridgway | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Anesthetist, Certified Registered | 
| Location | 1800 W University Blvd, Durant, Oklahoma | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1649717091 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 100088 (Oklahoma) | Primary | 
| 367500000X | Nurse Anesthetist, Certified Registered | 826001 (Texas) | Secondary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Blake Randall Ridgway, CRNA 1903 W Evergreen St, Durant, OK 74701-4615 Ph: (316) 644-3355  | Blake Randall Ridgway, CRNA 1800 W University Blvd, Durant, OK 74701-3006 Ph: (281) 249-5954  | 
Sean Phillip Klufa,  Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1800 W University Blvd, Durant, OK 74701 Phone: 941-360-1566  | |
Grant Roesler, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1400 Bryan Drive, Durant, OK 74702 Phone: 580-931-3312  | |
Mr. Robert James Austin Iii, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1800 W University Blvd, Durant, OK 74701 Phone: 580-924-3080  |