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DR. CLYDE EDWARD BLACK M.D.
>> Specialist >> Other Service ProvidersRegistrant NPI Number: 1346247640
Individual Registrant:DR. CLYDE EDWARD BLACK M.D.
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
425 E 10TH ST SUITE B ANNISTON, AL 36207-4787 US
Tel: 256-236-3485 Fax: 256-237-3787
Tel: 256-236-3485 Fax: 256-237-3787
Contact information for business:
425 E 10TH ST SUITE B ANNISTON, AL 36207-4787 US
Tel: 256-236-3485 Fax: 256-237-3787
Tel: 256-236-3485 Fax: 256-237-3787
Registration Information:
NPI: 1346247640
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 174400000X | Other Service Providers Specialist | AL | 5174 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
