Individual
DR. SUMPTER DUDLEY BLACKMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
207Q00000X
Family Medicine Physician
Primary
5754
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000454
—
AL
Enumeration date
05/23/2005
Last updated
09/15/2015
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