NPI 1619916186

Jonathan Blackmon, IDC

Practitioner Independent Duty Corpsman Saint Marys, GA

Practice location

Address: 603 Wild Grape Dr, Saint Marys, GA 31558-3619
Phone: (912) 573-2940
Mailing address: 881 Uss James Madison Rd Naval Submarine Support Center Medical Department, Kings Bay, GA 31547-2531

Registered specialties (2)

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

Other Military Health Care Provider providers in Georgia →

Medical Technologist

Technologists, Technicians & Other Technical Service Providers Taxonomy 246QM0706X

Other Specialist/Technologist, Pathology providers in Georgia →

Registry record

NPI: 1619916186
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Jun 2006
Record last updated: 12 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.