Physician Compare National (NPI:1992719421)

HEALTHCARE PROVIDER: DONALD L BLACKMON JR. MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1992719421
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6608059753
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110328000830
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BLACKMON
	Individual professional last name
Provider First Name	DONALD
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6160N DAVIS HWY 5
	Group Practice or individual's line 1 address
City	PENSACOLA
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	325046967
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100025
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SACRED HEART HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100093
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAPTIST HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100266
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	GULF BREEZE HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y