Individual
JUSTIN CLINT BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18 13TH AVE NE, HICKORY, NC 28601-3748
(828) 322-2644
(828) 327-2235
Mailing address
PO BOX 308, HICKORY, NC 28603-0308
(828) 322-2644
(828) 327-2235
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2018-01112
NC
208D00000X
General Practice Physician
LL35690
SC
Other
Enumeration date
06/26/2013
Last updated
05/13/2021
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