MR. William Thomas Black, OD

NPI #1063591162 in Caldwell, Idaho

Provider Information

NPI Number: 1063591162
Entity Type: Individual
Name: MR. William Thomas Black, OD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Nov 2, 2006
Last Updated: Aug 30, 2012

Practice Location

Address: 420 E ELM ST
City: Caldwell
State: Idaho
ZIP Code: 83605-4846
Phone: (208) 459-2020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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