Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACOB BLAINE OLDHAM
ActiveDR. JACOB BLAINE OLDHAM is a Orthopaedic Surgery healthcare provider located in LAKESIDE, Arizona. NPI 1033109632 is currently active in the NPPES registry. Verify at CMS.
Orthopaedic Surgery · LAKESIDE, AZ
Registration Details
- NPI Number
- 1033109632
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 25, 2005 (20.65855262759 yrs)
- Last Updated
- Oct 20, 2022
- Licenses
-
MD2005-0490 (NM)41236 (AZ)
Practice Information
- Address
-
4830 HIGHWAY 260 STE 103LAKESIDE, AZ, 859295851Browse AZ providers · Browse ZIP 85929
- Phone
- 9285378777
- Fax
- 9285371914
- Primary Specialty
-
Orthopaedic Surgery
207X00000X
- Additional Specialty
- Orthopaedic Surgery
Other Orthopaedic Surgery Providers in LAKESIDE, AZ
| Name | Credential | NPI |
|---|---|---|
| LAURA L VANDENHEEDE | M.D. | 1699749481 |
| IAN KAY BRIMHALL | DO | 1467652875 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.