MARY BLACK PHYSICIANS GROUP LLC

SPARTANBURG, SC
NPI1295823045
Entity TypeOrganization
Authorized ContactSOPHIA L ARWOOD
Director
615-628-6038
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Additional Taxonomies207R00000X Internal Medicine
207RG0100X Internal Medicine, Gastroenterology
207RI0200X Internal Medicine, Infectious Disease
207Y00000X Otolaryngology
208000000X Pediatrics
2085R0202X Radiology, Diagnostic Radiology
208600000X Surgery
2086S0105X Surgery, Surgery of the Hand
208800000X Urology
208C00000X Colon & Rectal Surgery
208D00000X General Practice
207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism
Enumeration Date2006-10-10
Last Update Date2014-01-22
Business Address
MARY BLACK PHYSICIANS GROUP LLC
130 DILLON DR
SPARTANBURG, SC 29307-1018
Phone number: 864-585-2027
Mailing Address
MARY BLACK PHYSICIANS GROUP LLC
PO BOX 689022 PROVIDER ENROLLMENT DEPARTMENT
FRANKLIN, TN 37068-9022
Phone number: 615-465-7000