Jonathan Blackmon, IDC Valid NPI

Individual provider · Independent Duty Corpsman · Saint Marys, GA

NPI

1619916186

Type

Individual (Type 1)

Primary specialty

Independent Duty Corpsman (Military Health Care Provider)

Specialty group

Other Service Providers

Taxonomy code

1710I1002X

Sex

Male

Sole proprietor

Yes

Enumerated

2006-06-06

Last updated

2021-08-12