Shawna C Blackmon in Tyler - Physician Assistant
Shawna C Blackmon - NPI 1487641536
Shawna C Blackmon is a Physician Assistant in Tyler, Texas. Shawna C Blackmon practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Shawna C Blackmon is 1487641536. The last update date is 2022-02-24.
Shawna C Blackmon's current location address is 3414 Golden Rd, Tyler, Texas. You can contact this provider via phone number 9039397500 and fax number 9039397728. The mailing address for Shawna C Blackmon is 3414 Golden Rd, Tyler, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shawna C Blackmon |
|---|---|
| Address | 3414 Golden Rd, Tyler, Texas |
| Phone Number | 9039397500 |
| Fax Number | 9039397728 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1487641536 |
|---|---|
| Provider Enumeration Date | 2005-10-04 |
| Last Updated Date | 2022-02-24 |
Provider Mailing Address Detail
| Address | 3414 Golden Rd |
|---|---|
| City | Tyler |
| State | Texas (TX) |
| Post Code | 757018336 |
| Phone Number | 9039397500 |
| Fax Number | 9039397728 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA04131 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| P00743048 | TX | RAILROAD MEDICARE | |
| 8360ND | TX | BLUE CROSS BLUE SHIELD | |
| 206265503 | TX | -- | |
| 206265502 | TX | -- | |
| 206265504 | TX | -- | |
| 206265501 | TX | -- | |
| 8Y8693 | TX | BCBS |
Post Comment/ Review Below
What is the Shawna C Blackmon's unique identification number?
The Shawna C Blackmon has been assigned the NPI (National Provider Identifier) Number 1487641536 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
What is the unique 10-digit identification code assigned to Shawna C Blackmon by the Centers for Medicare & Medicaid Services?
The Shawna C Blackmon has been issued the NPI (National Provider Identifier) 1487641536, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Shawna C Blackmon's physical address?
The Shawna C Blackmon is physically located at 3414 Golden Rd, in the city of Tyler, TX, with the postal code 757018336.
On what date did the Shawna C Blackmon receive its 1487641536 assignment from the Centers for Medicare & Medicaid Services?
The Shawna C Blackmon was assigned its 1487641536 by the Centers for Medicare & Medicaid Services on 2005-10-04.
As of what date were the details related to Shawna C Blackmon most recently updated or revised?
The information pertaining to Shawna C Blackmon, including its address, specialty, and other relevant details, was last updated or revised on 2022-02-24.