JACOB BLASDEL (NPI# 1558926683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558926683 |
Entity Type | Individual |
Full Name | JACOB BLASDEL |
Credential | DO |
Practice Address |
1923 S Utica Ave Tulsa OK 74104-6520 |
Mailing Address |
4502 E 41st St Tulsa OK 74135-2536 |
Practice Telephone | 9187442345 |
Enumeration Date | 2019-05-03 |
Last Update Date | 2019-05-03 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
4502 E 41st St, Tulsa, OK 741352536 | 9186194400 |
Street Address |
1923 S UTICA AVE |
City | TULSA |
State | OK |
Zip Code | 74104-6520 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174527667 | Mark Douglas Mills | Pharmacist | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2005-06-13 |
1043848880 | Saba Imani | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2020-03-28 |
1073146312 | Tammy Irene Joplin | Clinical Nurse Specialist | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2020-02-14 |
1962047563 | Houston Reed Slemp | Nurse Practitioner | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-11-07 |
1558903369 | Nicole Coburn | Physician Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-10-14 |
1124669643 | Jordan Beasley | Physician Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-10-06 |
1487217634 | Candice R Rogers | Student in an Organized Health Care Education/Training Program | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-04-15 |
1881158178 | Ellen Chadick | Anesthesiologist Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-01-30 |
1528522810 | Hannah Chadick | Anesthesiologist Assistant | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2019-01-30 |
1477033413 | Ashley Siobhan Carnley | Nurse Anesthetist, Certified Registered | 1923 S Utica Ave, Tulsa, OK 74104-6520 | 2018-08-20 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982253811 | Ultimate Health and Pain Management | Pain Medicine | 1844 East 15th Street, Tulsa, OK 74104 | 2019-09-04 |
1225691223 | David Murray | Student in an Organized Health Care Education/Training Program | 2100 S Wheeling Ave, Tulsa, OK 74104 | 2019-04-16 |
1083115828 | Susan Fortner | Counselor | 1328 S. Delaware Pl, Tulsa, OK 74104 | 2018-02-27 |
1033636915 | Mark Brizendine | Dietitian, Registered | Hillcrest Medical Center 1120 S. Utica Ave, Tulsa, OK 74104 | 2017-08-23 |
1295259067 | Demi Reyd Cook | Nurse Practitioner | 1717 A South Utica, Tulsa, OK 74104 | 2017-08-02 |
1851827059 | Oklahoma Cvs Pharmacy | Durable Medical Equipment & Medical Supplies | 1701 E 15th Street, Tulsa, OK 74104 | 2017-05-08 |
1801334982 | Jamie Lynne Miller | Internal Medicine | 2000 S. Wheeling Avenue Ste 510, Tulsa, OK 74104 | 2017-02-08 |
1578913430 | Donna Durant-macon | Registered Nurse | 315 South Utica, Tulsa, OK 74104 | 2016-06-21 |
1669833851 | Mbc Dental | Dentist | 401 S. Utica Ave, #a, Tulsa, OK 74104 | 2016-03-15 |
1518332170 | Neuro Dynamics LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 22 S Lewis, Tulsa, OK 74104 | 2015-12-08 |
Find all providers in zip 74104 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255931739 | Parker Grant Allan | Student in an Organized Health Care Education/Training Program | 5126 E 104th Pl, Tulsa, OK 74137-6082 | 2020-10-26 |
1003423369 | Armin Kalantari | Student in an Organized Health Care Education/Training Program | 7310 E 92nd St, Tulsa, OK 74133-6039 | 2020-09-29 |
1437766268 | Abigail Roberts | Student in an Organized Health Care Education/Training Program | 2657 S Oswego Pl, Tulsa, OK 74114-4719 | 2020-09-25 |
1275149577 | Jesse Taylor Strong | Student in an Organized Health Care Education/Training Program | 50 S Florence Ave, Tulsa, OK 74104-1714 | 2020-09-22 |
1376159632 | Nisha Rajagopal | Student in an Organized Health Care Education/Training Program | 6152 S Richmond Ave, Tulsa, OK 74136-1613 | 2020-09-21 |
1386250728 | Magera Shaw | Student in an Organized Health Care Education/Training Program | 1436 S Darlington Ave, Tulsa, OK 74112-6314 | 2020-09-21 |
1811503261 | Bridgette Molenda | Student in an Organized Health Care Education/Training Program | 5215 S Harvard Ave Apt K, Tulsa, OK 74135-3537 | 2020-09-21 |
1922613777 | Anna Claire Shadid | Student in an Organized Health Care Education/Training Program | 2122 E 47th Pl, Tulsa, OK 74105-4922 | 2020-09-09 |
1316552169 | Laura Warning | Student in an Organized Health Care Education/Training Program | 412 S Olympia Ave, Tulsa, OK 74127-8825 | 2020-09-09 |
1487269239 | James Maxwell Cox | Student in an Organized Health Care Education/Training Program | 4507 S Madison Pl, Tulsa, OK 74105-4564 | 2020-09-09 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.