Individual
JOSHUA MARION BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000 DAN PROCTOR DR, SAINT MARYS, GA 31558-3810
(800) 841-4236
Mailing address
PO BOX 1409, WAYCROSS, GA 31502-1409
(800) 841-4236
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
63632
GA
2085R0202X
Diagnostic Radiology Physician
ME110582
FL
208D00000X
General Practice Physician
001865
GA
Other
Enumeration date
05/21/2007
Last updated
09/03/2013
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