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DR. CLIFFORD P. BLACK M.D.

>> Specialist >> Other Service Providers

Registrant NPI Number: 1316903396

Individual Registrant:
DR. CLIFFORD P. BLACK M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1901 LEIGHTON AVE  ANNISTON, AL 36207-3270 US
Tel: 256-240-9660  Fax: 256-240-9636

Contact information for business:
1901 LEIGHTON AVE  ANNISTON, AL 36207-3270 US
Tel: 256-240-9660  Fax: 256-240-9636

Registration Information:
NPI: 1316903396
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y174400000XOther Service Providers
Specialist
AL00014219

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BLUE CROSS BLUE SHIELD051044834AL01
000044834AL05




HEALTH CARE JOBS AL - Page 1



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