Individual
GREGORY D BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7714 CONNER RD, SUITE 101, POWELL, TN 37849-3559
(865) 212-6350
(865) 212-6350
Mailing address
7714 CONNER RD, SUITE 101, POWELL, TN 37849-3559
(865) 212-6350
(865) 212-6350
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28729
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2
—
TN
Enumeration date
07/24/2006
Last updated
07/09/2007
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