Individual
DR. RONNIE BLOUNT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 FRIST ST, STE A, MACON, GA 31201
(478) 787-6910
(478) 254-5029
Mailing address
125 1ST ST, STE A, MACON, GA 31201-2692
(478) 787-6910
(478) 254-5029
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
039735
GA
2084P0800X
Psychiatry Physician
Primary
039735
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000648161A
—
GA
Enumeration date
11/10/2006
Last updated
04/23/2014
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