Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JASON LEE BLACKHAM, M.D.
ActiveSleep Medicine · OGDEN, UT
Registration Details
- NPI Number
- 1821293242
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 16, 2007 (18.850117144004 yrs)
- Last Updated
- Sep 22, 2011
- License
-
7216493-1205 (UT)
Practice Information
- Address
-
4403 HARRISON BLVDSUITE 2400OGDEN, UT, 844033271Browse UT providers · Browse ZIP 84403
- Phone
- 8013872750
- Fax
- 8013872755
- Primary Specialty
-
Sleep Medicine
207RS0010X
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.