Extended Family Medical Clinic

NPI #1720121395 in Mobile, Alabama

Provider Information

NPI Number: 1720121395
Entity Type: Organization
Organization Name: Extended Family Medical Clinic
Primary Specialty: Family Medicine
Enumeration Date: Feb 14, 2007
Last Updated: Mar 19, 2025

Practice Location

Address: 108 N CATHERINE ST
Address 2: SUITE A
City: Mobile
State: Alabama
ZIP Code: 36604-1304
Phone: (251) 438-7170

Authorized Official

Name: ANGELIA DENIESE BLACKMON, CRNP
Title: MEDICAL DIRECTOR
Phone: (251) 438-7170

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X
Family Medicine	207Q00000X	Primary

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