Individual
DR. KEVIN J BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
517 S EUCLID AVE, DEPT PSYCHIATRY, SAINT LOUIS, MO 63110-1007
(314) 286-1700
(314) 970-9094
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 286-1700
(314) 970-9094
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
37001
MO
2084P0800X
Psychiatry Physician
Primary
37001
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206946006
—
MO
Enumeration date
07/17/2006
Last updated
04/15/2025
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