Individual
WILLIAM S BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1006 FORD AVE, OWENSBORO, KY 42301-4677
(270) 688-2110
(270) 688-2111
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28129
KY
207QS0010X
Sports Medicine (Family Medicine) Physician
28129
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64281298
—
KY
Enumeration date
04/22/2006
Last updated
06/13/2023
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