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Individual

ALYSSA GAIL BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
155 BRICKLAYER ST, OLIVE HILL, KY 41164-1268
(606) 286-4152
(606) 286-2385
Mailing address
234 MEDICAL CIR, MOREHEAD, KY 40351-1194
(606) 780-5330
(606) 780-2362

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05595
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05595
STATE
KY
05
7100762470
KY
Enumeration date
03/27/2020
Last updated
06/06/2025
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