BLAKE MATTHEW REYNOLDS SOIDC
NPI 1316239197
Military Health Care Provider - Independent Duty Corpsman in Camp Lejeune, NC

Active since May 11, 2011
2D MSOB, BLDG. A-66, CAMP LEJEUNE, NC 28542(910) 440-7704 Get Directions Write a Review

NPPES record last updated: May 11, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Blake Matthew Reynolds Soidc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLAKE MATTHEW REYNOLDS SOIDC (NPI 1316239197) is an individual independent duty corpsman provider in Camp Lejeune, North Carolina and active in the NPI registry since May 2011.

NPPES Registry Identity

NPI1316239197
Entity TypeIndividualMale
Primary Taxonomy1710I1002X
Provider Legal NameBLAKE MATTHEW REYNOLDSCredential: SOIDC
Location Address2D MSOB, BLDG. A-66Camp Lejeune, NC 28542-0183
Mailing AddressPsc Box 20116, 2d Marine Special Operations BattalionCamp Lejeune, NC 28542-0116 · (910) 440-7704
Sole ProprietorNo
Enumeration DateMay 11, 2011
NPI 1316239197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers
Taxonomy Code1710I1002X
Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

2D MSOB, BLDG. A-66, Camp Lejeune, NC 28542

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1316239197, enumerated as an "individual" on May 11, 2011.

The provider is located at 2D MSOB, BLDG. A-66 CAMP LEJEUNE, NC 28542 and the phone number is (910) 440-7704.

Military Health Care Provider with taxonomy code 1710I1002X and a focus in Independent Duty Corpsman.