Individual
DR. HENRY COOPER BLACK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1210 W FARIS RD, GREENVILLE, SC 29605-4444
(864) 522-1800
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8614
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
17257
SC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
17257
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172574
—
SC
Enumeration date
05/04/2006
Last updated
05/06/2021
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