Individual
JAMES EDWARD BLACKSMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
689 YORKTOWN RD, LEWISBERRY, PA 17339-9258
(717) 932-4050
(717) 932-8072
Mailing address
946 INDIANA AVE, LEMOYNE, PA 17043-1406
(717) 761-2066
(717) 418-2389
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS002954L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006117040007
—
PA
01
—
126441F6K
MEDICARE PTAN
PA
Enumeration date
04/24/2006
Last updated
02/22/2017
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