Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JERRY D BLACKWELL JR JR., LAT
Active Sole ProprietorMR. JERRY D BLACKWELL JR JR., LAT is a Athletic Trainer healthcare provider located in THIBODAUX, Louisiana. NPI 1598473860 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · THIBODAUX, LA
Registration Details
- NPI Number
- 1598473860
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 7, 2022 (3.5783981743356 yrs)
- Last Updated
- Nov 7, 2022
- License
-
J00235 (LA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2498 PINERIDGE STTHIBODAUX, LA, 703013959Browse LA providers · Browse ZIP 70301
- Phone
- 9854467573
- Primary Specialty
-
Athletic Trainer
2255A2300X
Other Athletic Trainer Providers in THIBODAUX, LA
| Name | Credential | NPI |
|---|---|---|
| MR. GERARD ANTHONY WHITE | MED, ATC, LAT | 1780612234 |
| MR. MAYFIELD BOOTH ARMSTRONG | ATC | 1174768519 |
| MR. LARRY DANTONI | ATC | 1528347077 |
| MR. JOSEPH R. MCCLELLAND | ATC | 1386082618 |
| RUSSELL CARLISLE | ATC, LAT | 1578988218 |
| DANIELLE R ADAM | ATC, LAT, CPHT | 1467834192 |
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.