Individual
MR. DANIEL C BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
603 N PROGRESS AVE, SILOAM SPRINGS, AR 72761-4352
(479) 524-4141
(479) 549-2577
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PT2018-017
AR
Other
Enumeration date
03/27/2018
Last updated
03/28/2018
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