Individual
LEE ANN BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD.21391
AL
2084P0804X
Child & Adolescent Psychiatry Physician
MD.21391
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051039780
—
AL
05
—
115827
—
AL
05
—
115836
—
AL
01
—
1891741567
TRICARE SOUTH
AL
01
—
39780
BCBS
AL
01
—
511-02189
BCBS
AL
01
—
511-02194
BCBS
AL
01
—
511-03877
FEDERAL BC
AL
01
—
511-03879
FEDERAL BC
AL
01
—
98345
BCBS
AL
Enumeration date
05/25/2006
Last updated
12/29/2015
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