Jason Lee Blackham, M.D.

NPI #1821293242 in Ogden, Utah

Provider Information

NPI Number
1821293242
Entity Type
Individual
Name
Jason Lee Blackham, M.D.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Internal Medicine - Sports Medicine
Credential
M.D.
Enumeration Date
Jun 16, 2007
Last Updated
Sep 22, 2011

Practice Location

Address
4403 HARRISON BLVD
Address 2
SUITE 2400
City
Ogden
State
Utah
ZIP Code
84403-3271
Phone
(801) 387-2750

Specialties & Taxonomy Codes

Specialty
Internal Medicine - Sports MedicineSports Medicine

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