Jerad Robert Bludorn in Lake Norden - Chiropractor
Jerad Robert Bludorn - NPI 1629076435
Jerad Robert Bludorn is a Chiropractor in Lake Norden, South Dakota. Jerad Robert Bludorn practices all healthcare services and medical treatments related to Chiropractor. The NPI Number for Jerad Robert Bludorn is 1629076435. The last update date is 2011-11-17.
Jerad Robert Bludorn's current location address is 505 Main Ave, Lake Norden, South Dakota. You can contact this provider via phone number 6057853900 and fax number 6057853908. The mailing address for Jerad Robert Bludorn is 505 Main Ave, Lake Norden, South Dakota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jerad Robert Bludorn |
|---|---|
| Address | 505 Main Ave, Lake Norden, South Dakota |
| Phone Number | 6057853900 |
| Fax Number | 6057853908 |
| Sole Proprietor | Y |
| Credentials | DC |
NPI Number Detail
| NPI Number | 1629076435 |
|---|---|
| Provider Enumeration Date | 2005-07-14 |
| Last Updated Date | 2011-11-17 |
Provider Mailing Address Detail
| Address | 505 Main Ave |
|---|---|
| City | Lake Norden |
| State | South Dakota (SD) |
| Post Code | 572480252 |
| Phone Number | 6057853900 |
| Fax Number | 6057853908 |
Provider's Primary Taxonomy Detail
| Speciality | Chiropractor |
|---|---|
| Taxonomy | 111N00000X |
| Licence No | 1025 |
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Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its inte |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4995423 | BCBS | ||
| 7601960 | SD | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Jerad Robert Bludorn by the Centers for Medicare & Medicaid Services?
The Jerad Robert Bludorn has been issued the NPI (National Provider Identifier) 1629076435 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Jerad Robert Bludorn?
The Jerad Robert Bludorn is physically situated at 505 Main Ave, in the city of Lake Norden, state of SD, with the postal code 572480252.
What is Jerad Robert Bludorn's area of expertise and its corresponding taxonomy classification?
The Jerad Robert Bludorn's field of specialization is Chiropractor, and it falls under the taxonomy code 111N00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1629076435 to Jerad Robert Bludorn?
The Centers for Medicare & Medicaid Services assigned the 1629076435 to Jerad Robert Bludorn on 2005-07-14.
As of what date was the information regarding Jerad Robert Bludorn, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jerad Robert Bludorn, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2011-11-17.