Individual
JACOB BLASINGAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1000 MEDICAL CENTER DR, MONTICELLO, IL 61856-2116
(217) 762-6241
(217) 762-1702
Mailing address
1000 MEDICAL CENTER DR, MONTICELLO, IL 61856-2116
(217) 762-2115
(217) 762-1542
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007530
IL
Other
Enumeration date
02/03/2020
Last updated
12/13/2024
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