Healthcare Provider Details

I. General information

NPI: 1205191640
Provider Name (Legal Business Name): BLAKE AUSTIN WEEKS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 STARTOWN RD STE 101
HICKORY NC
28602-8307
US

IV. Provider business mailing address

1985 STARTOWN RD STE 101
HICKORY NC
28602-8307
US

V. Phone/Fax

Practice location:
  • Phone: 828-732-5530
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number10430
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number723
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00397
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: