Individual
DR. CLIFFORD P. BLACK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 LEIGHTON AVE, ANNISTON, AL 36207-3270
(256) 240-9660
(256) 240-9636
Mailing address
1901 LEIGHTON AVE, ANNISTON, AL 36207-3270
(256) 240-9660
(256) 240-9636
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00014219
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000044834
—
AL
01
—
051044834
BLUE CROSS BLUE SHIELD
AL
Enumeration date
04/26/2006
Last updated
02/09/2017
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