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W Kenny Blake MD LLC

Family Medicine Physician in Monticello, GA · enumerated 2011 · authorized official Wyatt Blake, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1093011314

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Registry record

Entity type Organization (Type 2)
Legal business name W Kenny Blake MD LLC
Practice address 545 Venture Court, Monticello, GA, 31064
Phone (706) 468-7002
Fax (706) 468-7020
Enumeration date Feb 3, 2011
Last updated in NPPES Feb 4, 2011

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Wyatt Blake
Title Owner
Phone (706) 468-7002

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is W Kenny Blake MD LLC located?
The practice location on file with NPPES is in Monticello, GA.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2011-02-04. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2011-02-04.