Black, William H

Black, William H is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. He recently has only one registered license in Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, which is considered as his primary health care specialty. Black, William H can be contacted via phone (601) 815-8000.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 815-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 22568 Mississippi

Profile Details

NPI number 1912166703
LBN Legal business name Black, William H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2008
Last updated Oct 6th, 2017 - about 7 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 1912166703 NPPES
Mississippi MEDICAID 05637711
Mississippi Other P01454816

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