Individual
ROBERT LEE BLACK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
640 ALDEN ST, MEADVILLE, PA 16335-2348
(814) 373-5255
(814) 373-5259
Mailing address
1034 GROVE ST, MEADVILLE, PA 16335-2945
(814) 373-5266
(814) 373-5269
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
06/07/2018
Last updated
04/01/2025
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