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DR. CLYDE EDWARD BLACK M.D.

>> Specialist >> Other Service Providers

Registrant NPI Number: 1346247640

Individual Registrant:
DR. CLYDE EDWARD BLACK M.D.
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

Contact information for business:
425 E 10TH ST SUITE B ANNISTON, AL 36207-4787 US
Tel: 256-236-3485  Fax: 256-237-3787

Registration Information:
NPI: 1346247640
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y174400000XOther Service Providers
Specialist
AL5174

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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