Blackwell, Jeremy Ty
Blackwell, Jeremy Ty is an individual health care provider with primary practice located at 1450 Jones Dairy Road Bldg 900, Jasper AL 35501-6108. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Blackwell, Jeremy Ty can be contacted via phone (205) 387-8159.Contact Information
Primary practice address
1450 Jones Dairy Road Bldg 900
Jasper AL 35501-6108
Phone: (205) 387-8159
Fax: (205) 387-8262
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 27715 | Alabama |
Profile Details
| NPI number | 1205053352 |
|---|---|
| LBN Legal business name | Blackwell, Jeremy Ty |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 19th, 2007 |
| Last updated | Feb 1st, 2013 - about 13 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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