Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Extended Family Medical Clinic

Organization Family Medicine Physician · NPI 1720121395

Extended Family Medical Clinic is a Family Medicine Physician 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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