Blackham, Jordan Lee

Blackham, Jordan Lee is an individual health care provider with primary practice located at 652 S Medical Center Dr Ste 120 , Saint George UT 84790-7077. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Student, Health Care / Student in an Organized Health Care Education/Training Program. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Blackham, Jordan Lee can be contacted via phone (435) 251-3600.

Contact Information

Primary practice address
652 S Medical Center Dr Ste 120 Saint George UT 84790-7077
Phone: (435) 251-3600
Fax: (435) 251-3601
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1790337046
LBN Legal business name Blackham, Jordan Lee
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2019
Last updated Nov 6th, 2020 - about 4 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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