Individual provider · Type 1 NPI

Dakota James Blackwelder, PA-STUDENT

Student in an Organized Health Care Education/Training Program · Fort Stewart, GA

NPI number 1467328401 Active

Practice location

1061 Harmon Ave
Fort Stewart, GA 31314-5641

Call (570) 801-7418 Map

Mailing address

1115 Marne Blvd
Hinesville, GA 31313-8092

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1467328401

Dakota James Blackwelder, PA-STUDENT's National Provider Identifier is 1467328401, issued on Oct 16, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fort Stewart, GA. The record was last updated on Oct 16, 2025.