Mr Paul A Blake Iv, DO (AS OF 5/31/2020) in Little Rock Afb, AR - Medicare Preventive Medicine

Mr Paul A Blake Iv, DO (AS OF 5/31/2020) is a medicare enrolled "Preventive Medicine - Aerospace Medicine" physician in Little Rock Afb, Arkansas. His current practice location is 1090 Arnold Dr, Little Rock Afb, Arkansas. You can reach out to his office (for appointments etc.) via phone at (501) 987-7319.

Mr Paul A Blake Iv is licensed to practice in Nebraska (license number 2470) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1639799158.

Contact Information

	Mr Paul A Blake Iv, DO (AS OF 5/31/2020)
	1090 Arnold Dr, Little Rock Afb, AR 72099-4933
	(501) 987-7319
	Not Available

Physician's Profile

Full Name	Mr Paul A Blake Iv
Gender	Male
Speciality	Preventive Medicine - Aerospace Medicine
Location	1090 Arnold Dr, Little Rock Afb, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1639799158
Provider Enumeration Date: 04/24/2020
Last Update Date: 10/01/2021

Medicare PECOS Information:

PECOS PAC ID: 4183012396
Enrollment ID: I20211020002136

Medical Identifiers

Medical identifiers for Mr Paul A Blake Iv such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639799158	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2083A0100X	Preventive Medicine - Aerospace Medicine	2470 (Nebraska)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Paul A Blake Iv is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Paul A Blake Iv, DO (AS OF 5/31/2020) 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 Ph: (501) 987-7319	Mr Paul A Blake Iv, DO (AS OF 5/31/2020) 1090 Arnold Dr, Little Rock Afb, AR 72099-4933 Ph: (501) 987-7319

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Preventive Medicine Doctors in Little Rock Afb, AR

Dr. Thomas Richard Degraff Iii, D.O. Preventive Medicine Medicare: Medicare Enrolled Practice Location: 101 Cms Williams Drive, Little Rock Afb, AR 72099 Phone: 501-987-6951
Dr. Timothy Arnell Netters Jr., M.D. Preventive Medicine Medicare: Medicare Enrolled Practice Location: 1090 Arnold Dr, Little Rock Afb, AR 72099 Phone: 501-987-7319

Mr Paul A Blake Iv, DO (AS OF 5/31/2020) - Medicare Preventive Medicine in Little Rock Afb, AR