Individual
JACOB BLASDEL
Active
Individual
JACOB BLASDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
76784
OK
390200000X
Student in an Organized Health Care Education/Training Program
76784
OK
Other
Enumeration date
05/03/2019
Last updated
09/21/2022
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