Mark Blackmon
NPI #1184359051 in Mcminnville, Tennessee
Provider Information
- NPI Number
- 1184359051
- Entity Type
- Individual
- Name
- Mark Blackmon
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Enumeration Date
- Jul 23, 2022
- Last Updated
- Sep 11, 2023
Practice Location
- Address
- 1559 SPARTA ST
- City
- Mcminnville
- State
- Tennessee
- ZIP Code
- 37110-1316
- Phone
- (931) 815-4000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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