Individual
DR. JAMES CLINTON BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
480 FLOYD RD STE A, SPARTANBURG, SC 29307-1518
(864) 582-2188
(864) 582-2117
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
2014000282
MO
207XX0801X
Orthopaedic Trauma Physician
Primary
83795
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043452741
—
MO
05
—
837955
—
SC
01
—
SCH6477628
MEDICARE PIN
SC
Enumeration date
03/27/2009
Last updated
11/30/2020
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