Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark Blackmon

Individual provider Physician Assistant · NPI 1184359051

Mark Blackmon is a Physician Assistant in McMinnville, Tennessee. Licensed in Tennessee. Registered with an NPI since 2022.

Licensed in
TN
In the registry since
2022
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Practice location Address checks out

1559 Sparta St
McMinnville, TN 37110-1316
Phone: (931) 815-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5627 (TN)

Record details

NPI number1184359051
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 23, 2022
Last updated in NPPESSeptember 11, 2023
Certification dateSeptember 11, 2023
Mailing addressPo Box 337, Lafayette, TN 37083-0337

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