Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Wyatt Kenny Blake, MD

Individual provider Family Medicine Physician · NPI 1548263064

Dr. Wyatt Kenny Blake, MD is a Family Medicine Physician in Gray, Georgia. Works from 2 locations. Licensed in Georgia.

Licensed in
GA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1005 Boulder Dr
Gray, GA 31032
Phone: (478) 621-2100
Fax: (478) 744-0481
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4421 Carnes St, Acworth, GA 30101-5305 — (478) 621-2072

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 047702 (GA)

Record details

NPI number1548263064
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 30, 2005
Last updated in NPPESJuly 17, 2019

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