Individual
JOHN A BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2400 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5314
(850) 877-2105
Mailing address
1115 W CALL ST, BIOMEDICAL SCIENCES, TALLAHASSEE, FL 32306-4300
(850) 645-9438
(850) 644-5781
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
029585
GA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME 107330
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00346244A
—
GA
01
—
61743
BCBS
FL
Enumeration date
04/10/2006
Last updated
06/18/2013
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