Robert Grant Black in Pocatello - Specialist
Robert Grant Black - NPI 1457499428
Robert Grant Black is a Specialist in Pocatello, Idaho. Robert Grant Black practices all healthcare services and medical treatments related to Specialist. The NPI Number for Robert Grant Black is 1457499428. The last update date is 2008-08-20.
Robert Grant Black's current location address is 285 Vista Drive, Pocatello, Idaho. You can contact this provider via phone number 2084781488 and fax number 2084781498. The mailing address for Robert Grant Black is 285 Vista Drive, Pocatello, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Robert Grant Black |
|---|---|
| Address | 285 Vista Drive, Pocatello, Idaho |
| Phone Number | 2084781488 |
| Fax Number | 2084781498 |
| Sole Proprietor | N |
| Credentials | PT |
NPI Number Detail
| NPI Number | 1457499428 |
|---|---|
| Provider Enumeration Date | 2007-02-02 |
| Last Updated Date | 2008-08-20 |
Provider Mailing Address Detail
| Address | 285 Vista Drive |
|---|---|
| City | Pocatello |
| State | Idaho (ID) |
| Post Code | 832010 |
| Phone Number | 2084781488 |
| Fax Number | 2084781498 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | PT-1705 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| D4888 | UT | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Robert Grant Black by the Centers for Medicare & Medicaid Services?
The Robert Grant Black has been issued the NPI (National Provider Identifier) 1457499428, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Robert Grant Black is physically located?
The Robert Grant Black is situated at the following address: 285 Vista Drive, Pocatello, ID 832010.
What is Robert Grant Black's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Robert Grant Black is Specialist, and the taxonomy code that classifies this field of practice is 174400000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1457499428 to Robert Grant Black?
The Centers for Medicare & Medicaid Services originally issued the 1457499428 to Robert Grant Black on 2007-02-02.
As of what date were the details pertaining to Robert Grant Black last refreshed?
The information related to the Robert Grant Black, including its address, specialty, and other relevant details, was last updated on 2008-08-20.
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