person
Jacob Blackman, OD
Student in an Organized Health Care Education/Training Program in Memphis, Tennessee
NPI 1558111575

Jacob Blackman is a Student in an Organized Health Care Education/Training Program based in Fayetteville, TN. Jacob Blackman practices in Memphis, TN and has the professional credentials of OD. The NPI Number for Jacob Blackman is 1558111575 and holds a License No. (Tennessee).

The current practice location address for Jacob Blackman is 1245 Madison Ave, Memphis, TN and can be reached out via phone at 901-722-3200.

Location: 1245 Madison Ave, Memphis, TN, 28306-9725
person
Provider Profile Details
NPI Number
1558111575
Provider Name
Jacob Blackman
Credential
OD
Provider Entity Type
Individual
Gender
Male
Address
1245 Madison Ave, Memphis, TN, 28306-9725
Phone Number
901-722-3200
Fax Number
Provider Enumeration Date
03/25/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
1245 Madison Ave
City
State
Zip
38104-2211
Phone Number
901-722-3200
Fax Number
person
Provider Business Mailing Address Details
Address
1245 Madison Ave
City
State
Zip
38104-2211
Phone Number
901-722-3200
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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