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Mason Blacker, MD
Military Health Care Provider in Green Village, New Jersey
NPI 1336908821

Mason Blacker is a Military Health Care Provider based in Green Village, NJ. Mason Blacker practices in Green Village, NJ and has the professional credentials of MD. The NPI Number for Mason Blacker is 1336908821 and holds a License No. (New Jersey).

The current practice location address for Mason Blacker is 55 Britten Rd, Green Village, NJ and can be reached out via phone at 217-552-4570.

Location: 55 Britten Rd, Green Village, NJ, 07935-3001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1336908821
Provider Name
Mason Blacker
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
55 Britten Rd, Green Village, NJ, 07935-3001
Phone Number
217-552-4570
Fax Number
Provider Enumeration Date
03/18/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
55 Britten Rd
City
Green Village
State
New Jersey
Zip
07935-3001
Phone Number
217-552-4570
Fax Number
person
Provider Business Mailing Address Details
Address
55 Britten Rd
City
Green Village
State
New Jersey
Zip
07935-3001
Phone Number
217-552-4570
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
()
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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