Individual
WILLIAM R BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1313 S RANGE LINE RD, JOPLIN, MO 64801-5588
(417) 623-2207
(417) 623-0342
Mailing address
1313 S RANGE LINE RD, JOPLIN, MO 64801-5588
(417) 623-2207
(417) 623-0342
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
106159
MO
Other
Enumeration date
10/23/2006
Last updated
02/10/2012
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