Douglas J Black MD LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

10894 Issued in NH

Legal business name

DOUGLAS J BLACK MD LLC

Practice address

875 Greenland Rd
Suite B4
Portsmouth, NH 03801

Phone

(603) 427-2577

Fax

(603) 427-0048

NPI assigned

Aug 23, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Douglas J Black MD LLC, MD

Title

Owner

Phone

(603) 427-2577

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1134435613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 GREENLAND RD",
            "address_2": "SUITE B4",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-427-2577",
            "fax_number": "603-427-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 GREENLAND RD",
            "address_2": "SUITE B4",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-427-2577",
            "fax_number": "603-427-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS J BLACK MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-23",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "BLACK  MD LLC",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-427-2577",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NH",
            "license": "10894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30200730",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Dorandi
• Derek Dore, PHARM.D.
• Jillian Doris
• Sarah Dostie, MED BCBA
• Brandon Charles Doucette, PHARMD.
• Madison Reese Dourdoufis, PA-C
• Peter J Dourdoufis, DO
• Angela Dow, MSW
• Kathleen F Dowd
• Jillian Ann Doyle, LGC

• Neurology Physician in Portsmouth, NH
• Providers in Portsmouth, NH by specialty
• Neurology Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.