JASON LEE BLACKHAM

OGDEN, UT
NPI1821293242
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RS0010X Internal Medicine, Sports Medicine
(Licence: UT  7216493-1205)
Enumeration Date2007-06-16
Last Update Date2011-09-22
Business Address
-- JASON LEE BLACKHAM M.D.
4403 HARRISON BLVD SUITE 2400
OGDEN, UT 84403-3271
Phone number: 801-387-2750
Mailing Address
-- JASON LEE BLACKHAM M.D.
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number: 801-387-2750
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