BLAKE MATTHEW REYNOLDS SOIDC
NPI 1316239197
Military Health Care Provider - Independent Duty Corpsman in Camp Lejeune, NC
- Individual
- Male
- Military Health Care Provider
- Independent Duty Corpsman
About BLAKE REYNOLDS
This page provides the complete NPI Profile along with additional information for Blake Reynolds, a provider established in Camp Lejeune, North Carolina with a medical specialization in Military Health Care Provider, focusing in independent duty corpsman . The healthcare provider is registered in the NPI registry with number 1316239197 assigned on May 2011. The practitioner's primary taxonomy code is 1710I1002X. The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1316239197 Verify this NPI
- Provider Name
- BLAKE MATTHEW REYNOLDS SOIDC
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2D MSOB, BLDG. A-66 CAMP LEJEUNE, NC 28542
- Location Phone
- (910) 440-7704
- Mailing Address
- PSC BOX 20116 2D MARINE SPECIAL OPERATIONS BATTALION CAMP LEJEUNE, NC 28542
- Mailing Phone
- (910) 440-7704
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-11-2011
- Last Update Date
- 05-11-2011
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Military Health Care Provider Independent Duty Corpsman
- Taxonomy Code
- 1710I1002X
- Type
- Other Service Providers
- Taxonomy Description
- 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.
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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.
