Individual
JONATHAN ANDREW BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 19TH ST S 112 LYONS HARRISON RESEARCH BUILDING, BIRMINGHAM, AL 35294-7050
(059) 340-1672
Mailing address
701 19TH ST S, BIRMINGHAM, AL 35233-1926
(205) 934-0167
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
36874
AL
Other
Enumeration date
06/10/2013
Last updated
06/28/2023
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