Individual
JARED BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
707 N ALVERNON WAY STE 101, TUCSON, AZ 85711-1830
(520) 694-8888
Mailing address
707 N ALVERNON WAY STE 101, TUCSON, AZ 85711-1830
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207Q00000X
AZ
207Q00000X
Family Medicine Physician
Primary
R80176
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
04/10/2023
Last updated
05/02/2023
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