Black, Bradley C

Black, Bradley C is an individual health care provider with primary practice located at 302 W 14Th St Ste 100, Jeffersonville IN 47130-3751. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Black, Bradley C can be contacted via phone (812) 284-0660.

Contact Information

Primary practice address
302 W 14Th St Ste 100 Jeffersonville IN 47130-3751
Phone: (812) 284-0660
Fax: (812) 284-3822
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 01027732A Indiana

Profile Details

NPI number 1356347884
LBN Legal business name Black, Bradley C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated May 12th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356347884 NPPES
Other 351995025 HUMANA
Other 4114033 HUMANA
Other 000000042712 HUMANA
Other 1051940 HUMANA
Other 351995025 HUMANA
Other 4114033 HUMANA
Other 245535P HUMANA
Other 918528 HUMANA
MEDICAID 100116130 HUMANA
Other 690178 HUMANA
Other 33654 HUMANA
Other 351995025 HUMANA
Other 351995025 HUMANA
Other 64755762 HUMANA

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