NPI 1881472371 · live from the CMS NPI Registry
Lara Blake
Family Medicine in Tupelo, MS. National Provider Identifier 1881472371, active.
NPI record
| NPI | 1881472371 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 845 S Madison St, Tupelo, MS 38801 |
| Practice phone | 662-377-3000 |
| Mailing address | 2056 New Chapel Rd, Nettleton, MS 38858 |
| Enumerated | September 18, 2023 |
| Last updated | September 18, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | 906281 (MS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.