Individual
DR. STEVEN G BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4424 S 7TH ST, TERRE HAUTE, IN 47801-0218
(812) 299-3937
(812) 299-8670
Mailing address
PO BOX 10218, TERRE HAUTE, IN 47801-0218
(812) 299-3937
(812) 299-8670
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2074
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100251270
—
IN
01
—
DF9692
MEDICARE RAILROAD CARRIER
IN
Enumeration date
05/17/2006
Last updated
05/05/2020
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