J. Larry Black MD PHD Pllc

NPI #1326239856 in Senatobia, Mississippi

Provider Information

NPI Number: 1326239856
Entity Type: Organization
Organization Name: J. Larry Black MD PHD Pllc
Primary Specialty: Internal Medicine
Enumeration Date: Aug 8, 2007
Last Updated: Dec 17, 2007

Practice Location

Address: 4364 HWY 51 SOUTH
City: Senatobia
State: Mississippi
ZIP Code: 38668-2534
Phone: (662) 562-6026

Authorized Official

Name: J LARRY BLACK, MD
Title: PRESIDENT
Phone: (662) 562-6026

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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