Gillette, Blake Paul
Gillette, Blake Paul is an individual health care provider with primary practice located at 325 W Center St , Spanish Fork UT 84660-2060. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Gillette, Blake Paul can be contacted via phone (801) 798-7301.Contact Information
Primary practice address
325 W Center St
Spanish Fork UT 84660-2060
Phone: (801) 798-7301
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 53004 | Minnesota |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 3615241205 | Utah |
Profile Details
| NPI number | 1356579213 |
|---|---|
| LBN Legal business name | Gillette, Blake Paul |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2009 |
| Last updated | Aug 26th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356579213 | NPPES |
| Minnesota | MEDICAID | ENROLLED | |
| Minnesota | MEDICAID | ENROLLED |
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