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:
Health care specialties
Specialty | Code | License # | 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 2 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1649559014 | NPPES |
Ohio | MEDICAID | 0067767 |
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