Blackmon, Sumpter Dudley

Blackmon, Sumpter Dudley is an individual health care provider with primary practice located at 321 Whiskey Run Rd , Camden AL 36726-2303. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Blackmon, Sumpter Dudley can be contacted via phone (334) 682-4128.

Contact Information

Primary practice address
321 Whiskey Run Rd Camden AL 36726-2303
Fax: (334) 682-9151
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5754 Alabama

Profile Details

NPI number 1972506194
LBN Legal business name Blackmon, Sumpter Dudley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2005
Last updated Sep 15th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972506194 NPPES
Alabama MEDICAID 000000454

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