Provider Demographics
NPI:1740085026
Name:JOSEPH BLAKE, OD INC
Entity type:Organization
Organization Name:JOSEPH BLAKE, OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:BLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-277-7550
Mailing Address - Street 1:872 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2310
Mailing Address - Country:US
Mailing Address - Phone:740-221-2831
Mailing Address - Fax:740-277-7599
Practice Address - Street 1:1726 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-9437
Practice Address - Country:US
Practice Address - Phone:740-277-7550
Practice Address - Fax:740-277-7599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty