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Contact Information

JONATHAN BLACKMON, IDC
603 WILD GRAPE DR
SAINT MARYS, GA31558-3619
 Phone: 912-573-2940
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Independent Duty Corpsman

1710I1002X
 

Medical Technologist

246QM0706X
Indicates primary specialty

NPI Profile & details for JONATHAN BLACKMON · (Male)

NPI # 1619916186
Status Active
Credentials IDC
Entity Individual
Enumeration date 06/06/2006
Last updated 08/12/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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