# BLACKSHEAR FAMILY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548477813
- **Authorized official:** LISA THRIFT (PRACTICE MANAGER)
- **Authorized official phone:** (912) 449-1501

## Contact information

- **Practice address:** 1218 ALICE ST, WAYCROSS, GA 31501-4525
- **Practice address phone:** (912) 284-9800
- **Practice address fax:** (912) 284-1711
- **Mailing address:** 1218 ALICE ST, WAYCROSS, GA 31501-4525
- **Mailing address phone:** (912) 284-9800
- **Mailing address fax:** (912) 284-1711

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 05/09/2011