Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Extended Family Medical Clinic

Organization Family Medicine Physician · NPI 1720121395

Extended Family Medical Clinic provides Family Medicine Physician services in Mobile, Alabama. Licensed in Alabama. Registered with an NPI since 2007.

Licensed in
AL
In the registry since
2007
Specialties on file
2

Practice location Address checks out

108 N Catherine St Ste A
Mobile, AL 36604-1304
Phone: (251) 438-7170
Fax: (251) 438-7173
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Clinic/Center Taxonomy 261Q00000X · Licence 1-073404 (AL)

Record details

NPI number1720121395
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Angelia Blackmon — Medical Director · (251) 438-7170
NPI enumeratedFebruary 14, 2007
Last updated in NPPESMarch 19, 2025
Certification dateMarch 19, 2025
Mailing address108 N Catherine St, Suite A, Mobile, AL 36604-1304

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