Blackmon, John A

Blackmon, John A is an individual health care provider with primary practice located at 2400 Miccosukee Rd , Tallahassee FL 32308-5314. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Blackmon, John A can be contacted via phone (850) 877-2105.

Contact Information

Primary practice address
2400 Miccosukee Rd Tallahassee FL 32308-5314
Phone: (850) 877-2105
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X ME 107330 Florida
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 029585 Georgia

Profile Details

NPI number 1184687352
LBN Legal business name Blackmon, John A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Jun 18th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184687352 NPPES
Florida Other 61743 BCBS
Florida MEDICAID 00346244A BCBS

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