Individual
DAVAUL BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2105 E SOUTH BLVD, MONTGOMERY, AL 36116-2409
(334) 747-2100
Mailing address
310 TELLURIDE LN, MIDLAND CITY, AL 36350-7034
(334) 791-8748
(334) 791-8748
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2025023280
AL
Other
Enumeration date
06/10/2025
Last updated
01/17/2026
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