Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | E-10515 | AR |
NPI | 1154548972 |
---|---|
Provider Name | Dr. David Albritton Black |
First Address | Little Rock, AR 72204-1720 |
Second Address | Little Rock, AR 72204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 06/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
583202YQCR | MEDICARE (01) | AR |