Individual
DR. JOHN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
V. B. HARRISON STUDENT HEALTH, REBEL DRIVE, UNIVERSITY, MS 38677
(662) 915-7274
(662) 915-5292
Mailing address
V. B. HARRISON STUDENT HEALTH, P.O. BOX 1848, UNIVERSITY, MS 38677
(662) 915-7274
(662) 915-5292
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16279
MS
2084P0800X
Psychiatry Physician
M0014343
TN
Other
Enumeration date
08/25/2006
Last updated
07/08/2007
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