Dr Jacob Steven Blackhurst, DDS in Apo, AA - Medicare Dentist Provider

Dr Jacob Steven Blackhurst, DDS is a medicare enrolled "Dentist" provider in Apo, Armed Forces Americas. His current practice location is Bldg 4-1838 Normandy Dr, Apo, Armed Forces Americas. You can reach out to his office (for appointments etc.) via phone at (910) 432-6190.

Dr Jacob Steven Blackhurst is licensed to practice in Utah (license number 11821131-992) 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 1154938520.

Contact Information

	Dr Jacob Steven Blackhurst, DDS
	Bldg 4-1838 Normandy Dr, Apo, AA 28307-7302
	(910) 432-6190
	Not Available

Healthcare Provider's Profile

Full Name	Dr Jacob Steven Blackhurst
Gender	Male
Speciality	Dentist
Location	Bldg 4-1838 Normandy Dr, Apo, Armed Forces Americas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154938520
Provider Enumeration Date: 09/29/2020
Last Update Date: 03/20/2023

Medicare PECOS Information:

PECOS PAC ID: 5496137846
Enrollment ID: I20220801002600

Medical Identifiers

Medical identifiers for Dr Jacob Steven Blackhurst such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154938520	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	11821131-992 (Utah)	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. Dr Jacob Steven Blackhurst 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
Dr Jacob Steven Blackhurst, DDS 735 Exeter St, Carthage, NC 28327-1455 Ph: (801) 669-1992	Dr Jacob Steven Blackhurst, DDS Bldg 4-1838 Normandy Dr, Apo, AA 28307-7302 Ph: (910) 432-6190

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Dentist in Apo, AA

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Dr. Sara Kingston, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: Offutt Afb 55th Dental Squadron, 2501 Capehart Road, Apo, AA 68113 Phone: 402-232-2273
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Dr Jacob Steven Blackhurst, DDS - Medicare Dentist in Apo, AA