Black, Damon A.
Black, Damon A. is an individual health care provider with primary practice located at 901 N Broad St Ne Suite 220, Rome GA 30161-5207. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Black, Damon A. can be contacted via phone (706) 291-2077.Contact Information
Primary practice address
901 N Broad St Ne Suite 220
Rome GA 30161-5207
Phone: (706) 291-2077
Fax: (706) 235-4177
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | 056409 | Georgia |
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 056409 | Georgia |
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | 056409 | Georgia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 056409 | Georgia |
Profile Details
| NPI number | 1225071616 |
|---|---|
| LBN Legal business name | Black, Damon A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Jul 23rd, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225071616 | NPPES |
| Georgia | MEDICAID | 649332244A | |
| Georgia | Other | 923350 |
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