Individual
JEFFREY M BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
929 SW SIMPSON AVE STE 300, BEND, OR 97702-3599
(541) 389-7741
(541) 278-8375
Mailing address
PO BOX 1517, PENDLETON, OR 97801-0410
(877) 708-1119
(541) 278-8349
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
55917
GA
207Q00000X
Family Medicine Physician
Primary
MD196707
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
724476151G
—
GA
Enumeration date
07/27/2006
Last updated
03/24/2023
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