Harry Black
Individual provider Active NPI Peer Specialist · Pryor, OK
NPI 1821546797 · NPPES record last updated Oct 20, 2016
Key facts
- NPI
- 1821546797
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 231 E Graham Ave
Pryor, OK 74361-2436 - Phone
- (918) 825-1405
- Fax
- (918) 825-1406
- NPI assigned
- Sep 20, 2016
- 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)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
231 E Graham Ave
Pryor, OK 74361-2436
Mailing address
231 E Graham Ave
Pryor, OK 74361-2436
Phone (918) 825-1405
Other providers in Pryor, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2016. 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.