Individual
DR. JEFFERY REUBEN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
109 PHYSICIANS DR STE B, GREER, SC 29650-2446
(864) 797-9170
(864) 797-9175
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
37486
GA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
89089
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000752661B
—
GA
Enumeration date
10/11/2006
Last updated
01/27/2023
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