Healthcare Provider Details

I. General information

NPI: 1013136811
Provider Name (Legal Business Name): JAMES E BLACKMAN JR. D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 01/04/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 E MIDTOWN PARK
MOBILE AL
36606-4141
US

IV. Provider business mailing address

79 E MIDTOWN PARK
MOBILE AL
36606-4141
US

V. Phone/Fax

Practice location:
  • Phone: 251-473-3571
  • Fax: 251-473-3572
Mailing address:
  • Phone: 251-473-3571
  • Fax: 251-473-3572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3655
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: