Blackmore, Jared

Blackmore, Jared is an individual health care provider with primary practice located at 10506A Montgomery Rd , Montgomery OH 45242-4402. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Blackmore, Jared can be contacted via phone (513) 865-5120.

Contact Information

Primary practice address
10506A Montgomery Rd Montgomery OH 45242-4402
Phone: (513) 865-5120
Fax: (513) 865-9875
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 50.003392 Ohio

Profile Details

NPI number 1649559014
LBN Legal business name Blackmore, Jared
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2011
Last updated May 31st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649559014 NPPES
Ohio MEDICAID 0067767

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