Mr John Vayden Blake, PA | |
118 Market St, Mannington, WV 26582-1131 | |
(304) 986-1750 | |
(304) 986-3742 |
Full Name | Mr John Vayden Blake |
---|---|
Gender | Male |
Speciality | Physician Assistant |
Location | 118 Market St, Mannington, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013994953 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363A00000X | Physician Assistant | 202 (West Virginia) | Secondary |
363A00000X | Physician Assistant | 929 (West Virginia) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mr John Vayden Blake, PA Po Box 1112, Fairmont, WV 26555-1112 Ph: (304) 986-1750 | Mr John Vayden Blake, PA 118 Market St, Mannington, WV 26582-1131 Ph: (304) 986-1750 |
Stephanie Lynn Courts, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 118 Market St, Mannington, WV 26582 Phone: 304-986-1750 Fax: 304-986-3742 | |
Amanda Hart, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 800 E Main St, Mannington, WV 26582 Phone: 304-986-2996 |