Individual
DR. MICAH SHAWN BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
775 POPLAR RD, SUITE 160, NEWNAN, GA 30265-8300
(770) 400-4630
(770) 254-6069
Mailing address
PO BOX 102321, ATLANTA, GA 30368-2321
(770) 801-2500
(770) 803-2121
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
059045
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I348220
MEDICARE PTAN
GA
Enumeration date
05/04/2007
Last updated
10/02/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us