Individual
MR. MARK HAMPTON BLOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2150 PEACHFORD RD STE Q, ATLANTA, GA 30338-6539
(678) 615-7032
Mailing address
11540 HWY 169, GLENNVILLE, GA 30427-6803
(912) 237-5540
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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