Individual
DR. JAMES E BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5505 ROSWELL RD, ATLANTA, GA 30342
(904) 234-5425
(229) 432-9550
Mailing address
811 HOLLY DR, ALBANY, GA 31705-4318
(904) 234-5425
(229) 432-9550
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
057777
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
359337
WELLCARE
GA
01
—
52991520-001
BCBS
GA
01
—
52991520-002
BCBS
GA
05
—
993056118A
—
GA
05
—
993056118B
—
GA
Enumeration date
07/18/2006
Last updated
09/26/2014
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