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Dr. Micah Shawn Blackmon, MD
Urology Physician in Newnan, Georgia
NPI 1588876411

Micah Shawn Blackmon is a Urology Physician based in Atlanta, GA. Micah Shawn Blackmon practices in Newnan, GA and has the professional credentials of MD. The NPI Number for Micah Shawn Blackmon is 1588876411 and holds a License No. 059045 (Georgia).

The current practice location address for Micah Shawn Blackmon is 775 Poplar Rd, Newnan, GA and can be reached out via phone at 770-400-4630 and via fax at 770-254-6069. You can also correspond with Micah Shawn Blackmon through the mailing address at PO BOX 102321, ATLANTA, GA - 30368-2321 (mailing address contact number: 770-801-2500).

Location: 775 Poplar Rd, Newnan, GA, 30368-2321
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1588876411
Provider Name
Micah Shawn Blackmon
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
775 Poplar Rd, Newnan, GA, 30368-2321
Phone Number
770-400-4630
Fax Number
770-254-6069
Provider Enumeration Date
05/04/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
202I348220 01 GA MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
775 Poplar Rd
City
Newnan
State
Georgia
Zip
30265-8300
Phone Number
770-400-4630
Fax Number
770-254-6069
person
Provider Business Mailing Address Details
Address
775 Poplar Rd
City
Newnan
State
Georgia
Zip
30265-8300
Phone Number
770-400-4630
Fax Number
770-254-6069
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Urology
Speciality
-
Taxonomy
208800000X
License No.
059045 (Georgia)
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
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