DR. Lance Michael Black, M.D.

NPI #1508957325 in Eglin Afb, Florida

Provider Information

NPI Number: 1508957325
Entity Type: Individual
Name: DR. Lance Michael Black, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Credential: M.D.
Enumeration Date: Sep 27, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 307 BOATNER RD
Address 2: SUITE 114
City: Eglin Afb
State: Florida
ZIP Code: 32542-1391
Phone: (850) 883-9624

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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