Individual
DR. MARY LEWIS BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-7300
Mailing address
300 W HOSPITAL RD, FORT GORDON, GA 30905-5741
(706) 787-7300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
059094
GA
Other
Enumeration date
03/12/2007
Last updated
11/17/2025
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