NPI 1700149648 · live from the CMS NPI Registry
Gary Chase Black, M.D.
Anesthesiology, Pain Medicine in Dayton, TN. National Provider Identifier 1700149648, active.
NPI record
| NPI | 1700149648 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Anesthesiology, Pain Medicine 207LP2900X |
| Practice location | 9400 Rhea County Hwy, Dayton, TN 37321 |
| Practice phone | 423-285-5220 |
| Mailing address | 167 Ashley Ave, Suite 301, Msc 912, Charleston, SC 29425 |
| Enumerated | June 15, 2012 |
| Last updated | June 1, 2018 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Anesthesiology | 207L00000X | LL34886 (SC) |
| Anesthesiology, Pain Medicine primary | 207LP2900X | 55829 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.