Individual
JOSHUA T BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
107 BRANDON RD, STARKVILLE, MS 39759
(662) 615-3771
(662) 615-3775
Mailing address
PO BOX 1326, STARKVILLE, MS 39760-1326
(662) 615-2830
(662) 615-2836
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25884
MS
207Q00000X
Family Medicine Physician
38401
SC
Other
Enumeration date
05/04/2015
Last updated
07/03/2018
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