Jeremy Ty Blackwell, M.D.

NPI #1205053352 in Jasper, Alabama

Provider Information

NPI Number
1205053352
Entity Type
Individual
Name
Jeremy Ty Blackwell, M.D.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Family Medicine
Credential
M.D.
Enumeration Date
Apr 19, 2007
Last Updated
Feb 1, 2013

Practice Location

Address
1450 JONES DAIRY ROAD
Address 2
BLDG 900
City
Jasper
State
Alabama
ZIP Code
35501-6108
Phone
(205) 387-8159

Specialties & Taxonomy Codes

Specialty
Family Medicine

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