| Doctor Name: | KENNETH D BLAKE |
| NPI Number: | 1174622070 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 41202 |
| Business Practice Address: | 10103 Ridgegate Pkwy Ste 208 Lonetree, CO - 801245520 |
| Business Phone Number: | 3035355350 |
| Business Fax Number: | 3035355353 |
| Mailing Address: | 10103 Ridgegate Pkwy, Ste 208 LONETREE |
| State: | CO |
| Postal Code: | 801245520 |
| Phone Number: | 3035355350 |
| Fax Number: | 3035355353 |
| NPI Enumeration Date: | 09/21/2006 |
| NPI Last Update Date: | 05/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208C00000X |
| License Number: | 41202 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Colon & Rectal Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |