Organization
THOMAS C BLACK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS C BLACK MD (OWNER)
(816) 942-8008
Entity
Organization
Contact information
Practice address
1010 CARONDELET DR, SUITE 103, KANSAS CITY, MO 64114-4821
(816) 942-8008
(816) 942-5314
Mailing address
1010 CARONDELET DR, SUITE 103, KANSAS CITY, MO 64114-4821
(816) 942-8008
(816) 942-5314
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R3026
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04192051
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/14/2006
Last updated
04/20/2008
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