Individual
DR. THOMAS C BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1010 CARONDELET DR, SUITE 103, KANSAS CITY, MO 64114-4821
(816) 942-8008
(816) 942-5314
Mailing address
1010 CARONDELET DR, SUITE 103, KANSAS CITY, MO 64114-4821
(816) 942-8008
(816) 942-5314
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
R3026
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04192051
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/17/2006
Last updated
07/08/2007
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