Blackmon, Thomas

Blackmon, Thomas is an individual health care provider with primary practice located at 217 E Carolina Ave , Hartsville SC 29550-4305. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Blackmon, Thomas can be contacted via phone (843) 332-4141.

Contact Information

Primary practice address
217 E Carolina Ave Hartsville SC 29550-4305
Phone: (843) 332-4141
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1053431064
LBN Legal business name Blackmon, Thomas
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2007
Last updated Jul 8th, 2007 - about 18 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 1053431064 NPPES
South Carolina MEDICAID 376241

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