Search › Georgia › 1710I1002X
Jonathan Blackmon, IDC
NPI 1619916186 · on the registry since 2006 · sole proprietor
Practice
- Address
- 603 Wild Grape Dr
Saint Marys, GA 31558 - Phone
- (912) 573-2940
Registry record
- Primary taxonomy
- 1710I1002X
1710I1002X
- Also registered as
- 246QM0706X
- Sex
- Male
- Record last updated
- 2021-08-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia