MEDICARE: ZACHARY BLACK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	307113	KY

General Provider Information

NPI Number	:	1528601721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY BLACK

Provider Business Mailing Address
First Line	:	64 FERRY ST
Second Line	:
City	:	WINFIELD
State	:	WV
Zip	:	25213-9350
Country	:	US
Telephone Number	:	304-710-0418
Fax Number	:

Provider Business Practice Location Address
First Line	:	952 COMMERCIAL DR
Second Line	:
City	:	RICHMOND
State	:	KY
Zip	:	40475-3402
Country	:	US
Telephone Number	:	859-624-5830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2019
Last Update Date	:	05/06/2026

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Directions to “ ZACHARY BLACK ” Practice Location

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