Jacob I Blazzard, PA-C is a medicare enrolled "Physician Assistant" in Clarkston, Washington. His current practice location is
1433 5th St, Clarkston, Washington. You can reach out to his office (for appointments etc.) via phone at
(509) 758-5141.
Jacob I Blazzard is licensed to practice in Washington (license number PA60099484) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1326125485.
Provider's Profile
Full Name | Jacob I Blazzard |
---|
Gender | Male |
---|
Speciality | Physician Assistant |
---|
Location | 1433 5th St, Clarkston, Washington |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1326125485
- Provider Enumeration Date: 11/01/2006
- Last Update Date: 04/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 9335168392
- Enrollment ID: I20100429000646
Medical Identifiers
Medical identifiers for Jacob I Blazzard such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1326125485 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | PA-1221 (Idaho) | Secondary |
363AM0700X | Physician Assistant - Medical | 361 (Wyoming) | Secondary |
363AM0700X | Physician Assistant - Medical | PA60099484 (Washington) | Secondary |
363A00000X | Physician Assistant | PA60099484 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacob I Blazzard is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jacob I Blazzard, PA-C 901 Rachel St, Troy, ID 83871-6002 Ph: (208) 310-2777 | Jacob I Blazzard, PA-C 1433 5th St, Clarkston, WA 99403-2714 Ph: (509) 758-5141 |
Reviews and Comments