Black, John B
Black, John B is an individual health care provider with primary practice located at 11 Upper Riverdale Rd Sw , Riverdale GA 30274-2615. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Black, John B can be contacted via phone (770) 991-8000.Contact Information
Primary practice address
11 Upper Riverdale Rd Sw
Riverdale GA 30274-2615
Phone: (770) 991-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 031702 | Georgia |
Profile Details
| NPI number | 1548247729 |
|---|---|
| LBN Legal business name | Black, John B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2005 |
| Last updated | Jul 18th, 2012 - about 12 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 | 1548247729 | NPPES |
| Georgia | MEDICAID | 000400573 |
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