Individual
JORDON BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
501 CROWN POINTE WAY, LAWRENCEVILLE, GA 30046
(678) 344-8900
Mailing address
1551 JANMAR RD, SNELLVILLE, GA 30078-5606
(470) 579-5600
(678) 691-0506
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
12984
GA
363AS0400X
Surgical Physician Assistant
Primary
12984
GA
363AS0400X
Surgical Physician Assistant
12984
—
Other
Enumeration date
04/09/2025
Last updated
04/28/2025
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