Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Demetrious J. Blackmon, MD

Individual provider Internal Medicine Physician · NPI 1578592994

Dr. Demetrious J. Blackmon, MD is a Nephrology in Stockbridge, Georgia. Graduated from University of South Alabama College of Medicine in 2002, 24 years ago. Practices with Preferred Vascular Services Northwest LLC, a 13-clinician group. Licensed in Georgia and Tennessee.

Years since qualifying
24
Trained at
University of South Alabama College of Medicine
Licensed in
GA, TN
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

250 Village Center Pwky Ste 100
Stockbridge, GA 30281-9044
Phone: (678) 289-0508
Fax: (678) 289-0124
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 57778 (GA)
Internal Medicine Physician Taxonomy 207R00000X · Licence MD38696 (TN)

Record details

NPI number1578592994
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 30, 2006
Last updated in NPPESMarch 4, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEPHROLOGY
Also practisesINTERNAL MEDICINE
Medical schoolUNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Preferred Vascular Services Northwest Llc — 13 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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