NPI 1508206285 · live from the CMS NPI Registry
Justin Clint Black, MD
Radiology, Diagnostic Radiology in Hickory, NC. National Provider Identifier 1508206285, active.
NPI record
| NPI | 1508206285 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 18 13th Ave Ne, Hickory, NC 28601 |
| Practice phone | 828-322-2644 |
| Mailing address | Po Box 308, Hickory, NC 28603 |
| Enumerated | June 26, 2013 |
| Last updated | May 13, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice | 208D00000X | LL35690 (SC) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | 2018-01112 (NC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.