Individual provider · Type 1 NPI

Matthew Jay Blocksom

Student in an Organized Health Care Education/Training Program · Demorest, GA

NPI number 1134052616 Active

Practice location

1021 Central Ave
Demorest, GA 30535-5252

Call (706) 778-3000 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1134052616

Matthew Jay Blocksom's National Provider Identifier is 1134052616, issued on Jun 4, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Demorest, GA. The record was last updated on Jun 4, 2026.