DR. CHARLES D BLACKMON (NPI# 1255354924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255354924 |
| Entity Type | Individual |
| Full Name | DR. CHARLES D BLACKMON |
| Credential | MD |
| Practice Address |
109 Regency Place West Monroe LA 71291 |
| Mailing Address |
130 Desiard St. Ste 355 Monroe LA 71201-7363 |
| Practice Telephone | 3188129999 |
| Practice Fax Number | 3183239339 |
| Mailing Telephone | 3188077875 |
| Mailing Fax Number | 3188129997 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2011-09-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 03852R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1191728 | 05 |
| Street Address |
109 REGENCY PLACE |
| City | WEST MONROE |
| State | LA |
| Zip Code | 71291 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518515279 | Bayou Belle Wellness | Chiropractor | 108 Zephyr St, West Monroe, LA 71291 | 2019-08-27 |
| 1710546593 | Stroolamb, LLC | Technician | 201 Trenton Street, Suite 1, West Monroe, LA 71291 | 2019-06-06 |
| 1588190714 | Varnado Delmore | Case Manager/Care Coordinator | 100 Patton Dr., West Monroe, LA 71291 | 2017-05-09 |
| 1518419373 | Kristana Haynes | Counselor | 241 Blanchard Street, Apt #3202, West Monroe, LA 71291 | 2016-10-27 |
| 1295190841 | Charles A Hudson | Counselor | 307 North 6th, West Monroe, LA 71291 | 2015-12-28 |
| 1790157329 | Catherine Yearby | Counselor | 1912 N 7th St, Apt 137, West Monroe, LA 71291 | 2015-10-22 |
| 1447628235 | Julia Wroten Terral | Dental Hygienist | 5454 Cypress St., West Monroe, LA 71291 | 2015-09-10 |
| 1528474954 | Nastosha Allen Griffin | Student in an Organized Health Care Education/Training Program | 2500 N. 7th Street #500, West Monroe, LA 71291 | 2014-07-07 |
| 1891109351 | Russell Roark | Pharmacist | 5251 Cypress Street, West Monroe, LA 71291 | 2014-06-12 |
| 1013328996 | The Foot and Ankle Clinic of West Monroe, LLC | Podiatrist | 2269 Arkansas Road, West Monroe, LA 71291 | 2014-05-14 |
| Find all providers in zip 71291 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649800301 | Allcare Medical | Family Medicine | 115 Smith St, West Monroe, LA 71292-6046 | 2020-01-22 |
| 1326058918 | Clyde E Elliott | Family Medicine | 304 Circle Dr, West Monroe, LA 71291 | 2006-08-08 |
| 1356376602 | West Monroe Care Center LLC | Family Medicine | 1416 Natchitaches Road, West Monroe, LA 71292 | 2006-07-12 |
| 1497799456 | Steven H Mcmahan | Family Medicine | 1900 N 7th St, West Monroe, LA 71291-4416 | 2006-06-16 |
| 1508824970 | Mark Freeman Dollar | Family Medicine | 122 Professional Dr, West Monroe, LA 71291-5332 | 2006-05-03 |
| 1982670923 | One Source Medical Management, Inc. | Family Medicine | 2933 Cypress St Ste 1, West Monroe, LA 71291 | 2006-02-28 |
| 1013983592 | Marshall Vashon Sanson | Family Medicine | 2309 Arkansas Rd, West Monroe, LA 71291-7820 | 2006-02-24 |
| 1417931841 | Warren Attwood Daniel Jr. | Family Medicine | 109 Regency Pl, West Monroe, LA 71291-4453 | 2005-11-30 |
| 1770191157 | Tiffany S Freeman | Family Medicine | 503 Mcmillan Rd, West Monroe, LA 71291-5327 | 2020-07-21 |
| 1013486059 | Physician Group of Louisiana Inc | Family Medicine | 1900 N 7th St, West Monroe, LA 71291-4416 | 2018-11-20 |
| Find all providers in WEST MONROE | ||||
| City | WEST MONROE |
| Zip Code | 71291 |
Please comment or provide details below to improve the information on DR. CHARLES D BLACKMON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.