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General NPI Number Information
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NPI Number | 1043452741
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Entity Type | Individual
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Provider Name | JAMES CLINTON BLACK MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 480 FLOYD RD STE A
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City | SPARTANBURG
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State | SC
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Zip | 29307-1518
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Country | US
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Telephone | 864-582-2188
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Fax | 864-582-2117
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Provider Business Mailing Address
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Address Line | PO BOX 743070
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City | ATLANTA
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State | GA
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Zip | 30374-3070
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Country | US
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Telephone | 864-560-4304
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | 2014000282
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | 83795
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License Number State | SC
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