Jerry N Black Surgical Suite

NPI #1992896310 in Buckhannon, West Virginia

Provider Information

NPI Number: 1992896310
Entity Type: Organization
Organization Name: Jerry N Black Surgical Suite
Primary Specialty: Ophthalmology
Enumeration Date: Sep 28, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 10 AMALIA DRIVE
City: Buckhannon
State: West Virginia
ZIP Code: 26201
Phone: (304) 472-2100

Authorized Official

Name: NORMA L HAYMOND
Title: ADMINISTRATOR
Phone: (304) 472-2100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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