Roy Black

NPI 1326582255 · on the registry since 2016 · sole proprietor

Practice

Address: 735 Main St N
New Ellenton, SC 29809
Phone: (803) 443-0077
Fax: (803) 443-0078
Organisation at this address: Main St Medical - New Ellenton Llc
Hibbitts Enterprises Long Term Care Division Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: 183500000X
183500000X
Licence states on file: SC
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2016-12-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in South Carolina