John Black, M.D.
Individual provider Active NPI Psychiatry Physician · University, MS
NPI 1609984376 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609984376
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 16279 (MS)
- Practice address
- V. B. Harrison Student Health
Rebel Drive
University, MS 38677 - Phone
- (662) 915-7274
- Fax
- (662) 915-5292
- NPI assigned
- Aug 25, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16279 | MS | MD | Psychiatry Physician |
| M0014343 | TN | MD | Psychiatry Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 16279 | MS | Yes |
| Psychiatry Physician | 2084P0800X | M0014343 | TN |
Addresses
Primary practice location
V. B. Harrison Student Health
Rebel Drive
University, MS 38677
Mailing address
V. B. Harrison Student Health
P.O. Box 1848
University, MS 38677
Phone (662) 915-7274
Other providers in University, MS
- Ashlyn Brianna Alverson
- Mariana Areli Anaya
- Kami Lynn Baker
- Tony F. Barnett Jr.
- Ketrail Devin Bellamy
- Mary Ward Black
- Ann L. Bond
- Nicholas Bosley
- Derionne Brooks
- Ethan Brown
All providers in University, MS · Psychiatry Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.