# MARY BLACK HEALTH SYSTEM LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mary Black Gastroenterology Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689697807
- **Authorized official:** REBECCA HURLEY (SENIOR VICE PRESIDENT)
- **Authorized official phone:** (214) 473-3993

## Contact information

- **Practice address:** 11 DOCTORS PARK DR, SPARTANBURG, SC 29307-1024
- **Practice address phone:** (864) 342-1435
- **Mailing address:** 11 DOCTORS PARK DR, SPARTANBURG, SC 29307-1024
- **Mailing address phone:** (864) 342-1435

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/26/2006
- **Last updated:** 09/11/2025