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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