Individual
LEE BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
580 W 8TH ST, 6TH FLOOR, SUITE 6005, JACKSONVILLE, FL 32209-6533
(904) 244-3990
(904) 244-3455
Mailing address
5003 S MIAMI BLVD, STE 300, DURHAM, NC 27703-8589
(919) 354-0840
(877) 840-6694
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
202100603
NC
2084P0800X
Psychiatry Physician
86392
SC
390200000X
Student in an Organized Health Care Education/Training Program
TRN24684
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/28/2017
Last updated
09/29/2021
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