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Organization
DR SUMPTER D BLACKMON PA
Active
Organization
DR SUMPTER D BLACKMON PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUMPTER DUDLEY BLACKMON M.D. (PRESIDENT)
(334) 682-4128
Entity
Organization
Contact information
Practice address
321 WHISKEY RUN RD, CAMDEN, AL 36726-2303
(334) 682-4128
(334) 682-9151
Mailing address
PO BOX 699, CAMDEN, AL 36726-0699
(334) 682-4128
(334) 682-9151
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
5754
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000454
—
AL
Enumeration date
11/21/2006
Last updated
02/02/2010
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