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Organization

ALAN S BLACK MD PC

Active
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Organization

ALAN S BLACK MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALAN SCOTT BLACK MD (PRESIDENT)
(706) 667-0453
Entity
Organization

Contact information

Practice address
2907 LAKE FOREST DR, AUGUSTA, GA 30909-3025
(706) 667-0453
Mailing address
2907 LAKE FOREST DR, AUGUSTA, GA 30909-3025
(706) 667-0453

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
34542
GA

Other

Enumeration date
05/02/2008
Last updated
05/02/2008
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