Black, Jeffery Reuben
Black, Jeffery Reuben is an sole proprietor health care provider with primary practice located at 109 Physicians Dr Ste B , Greer SC 29650-2446. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Black, Jeffery Reuben can be contacted via phone (864) 797-9170.Contact Information
Primary practice address
109 Physicians Dr Ste B
Greer SC 29650-2446
Phone: (864) 797-9170
Fax: (864) 797-9175
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 37486 | Georgia |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 89089 | South Carolina |
Profile Details
| NPI number | 1508954975 |
|---|---|
| LBN Legal business name | Black, Jeffery Reuben |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 11th, 2006 |
| Last updated | Jan 27th, 2023 - about last year |
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 | 1508954975 | NPPES |
| Georgia | MEDICAID | 000752661B |
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