Landry, Blake Anthony

Landry, Blake Anthony is an individual health care provider with primary practice located at 148 Bill Carruth Pkwy Ste 100 , Hiram GA 30141-3756. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Landry, Blake Anthony can be contacted via phone (770) 422-1372.

Contact Information

Primary practice address
148 Bill Carruth Pkwy Ste 100 Hiram GA 30141-3756
Phone: (770) 422-1372
Fax: (678) 363-5170
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X TA1743 Alabama

Profile Details

NPI number 1134477524
LBN Legal business name Landry, Blake Anthony
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2012
Last updated Oct 30th, 2019 - about 7 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.

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