DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JONATHAN BLACKMON, IDC

Active Sole Proprietor

Independent Duty Corpsman · SAINT MARYS, GA

Registration Details

NPI Number
1619916186
Provider Type
Individual
Gender
Male
NPI Issued
Jun 6, 2006 (19.878572465952 yrs)
Last Updated
Aug 12, 2021
Sole Proprietor
Yes

Practice Information

Address
603 WILD GRAPE DR
SAINT MARYS, GA, 315583619
Browse GA providers · Browse ZIP 31558
Phone
9125732940
Primary Specialty
Independent Duty Corpsman
1710I1002X
Additional Specialty
Independent Duty Corpsman

Other Independent Duty Corpsman Providers in SAINT MARYS, GA

Name Credential NPI
RICHARD COLLIER NEAL 1619955655
SEAN MASON 1780640722
MR. DAVID MICHAEL HOLT IDC 1225156441
ALEXANDRA L RICHEY 1528721412
MR. JACOB MATTHEW NELSON IDHS 1053037887
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.