Individual
BARRY G. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1122 14TH AVE SE, DECATUR, AL 35601-3361
(256) 560-2890
(256) 350-2609
Mailing address
1900 FLINT RD SE, DECATUR, AL 35601-6031
(256) 353-0626
(256) 350-2609
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-066229
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51526755
BCBS OF AL PIN
—
Enumeration date
04/27/2006
Last updated
07/24/2007
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