Individual
MR. ALVIN BLACKMON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-7763
Mailing address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-7763
Taxonomy
Speciality
Code
Description
License number
State
1835N0905X
Nuclear Pharmacist
017025
LA
1835N0905X
Nuclear Pharmacist
Primary
0202205702
VA
Other
Enumeration date
03/18/2011
Last updated
03/18/2011
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