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Jonathan Taylor Blackmon, DO
Student in an Organized Health Care Education/Training Program in Opelika, Alabama
NPI 1679142335

Jonathan Taylor Blackmon is a Student in an Organized Health Care Education/Training Program based in Opelika, AL. Jonathan Taylor Blackmon practices in Opelika, AL and has the professional credentials of DO. The NPI Number for Jonathan Taylor Blackmon is 1679142335 and holds a License No. (Alabama).

The current practice location address for Jonathan Taylor Blackmon is 2000 Pepperell Pkwy, Opelika, AL and can be reached out via phone at 334-528-3035 and via fax at 334-528-1661.

Location: 2000 Pepperell Pkwy, Opelika, AL, 36801-5452
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679142335
Provider Name
Jonathan Taylor Blackmon
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
2000 Pepperell Pkwy, Opelika, AL, 36801-5452
Phone Number
334-528-3035
Fax Number
334-528-1661
Provider Enumeration Date
06/17/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2000 Pepperell Pkwy
City
Opelika
State
Alabama
Zip
36801-5452
Phone Number
334-528-3035
Fax Number
334-528-1661
person
Provider Business Mailing Address Details
Address
2000 Pepperell Pkwy
City
Opelika
State
Alabama
Zip
36801-5452
Phone Number
334-528-3035
Fax Number
334-528-1661
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
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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