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1821293242
JASON LEE BLACKHAM
OGDEN, UT
NPI
1821293242
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RS0010X Internal Medicine, Sports Medicine
(Licence: UT 7216493-1205)
Enumeration Date
2007-06-16
Last Update Date
2011-09-22
Business Address
-- JASON LEE BLACKHAM M.D.
4403 HARRISON BLVD SUITE 2400
OGDEN, UT 84403-3271
Phone number: 801-387-2750
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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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