Search › Georgia › 207Q00000X
Wyatt Blake, MD
NPI 1548263064 · on the registry since 2005
Practice
- Address
- 1005 Boulder Dr
Gray, GA 31032 - Phone
- (478) 621-2100
- Fax
- (478) 744-0481
- Organisation at this address
- Community Primary Care Of Georgia Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 21
Additional practice sites
- 4421 Carnes St, Acworth, GA
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-07-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia