Individual
DR. RANDALL WAYNE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5204 W REDBUD STREET, ROGERS, AR 72758
(479) 636-0110
(479) 631-0491
Mailing address
5204 W REDBUD STREET, ROGERS, AR 72758
(479) 636-0110
(479) 631-0491
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
C7458
AR
Other
Enumeration date
05/01/2006
Last updated
07/15/2014
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