Provider Demographics
NPI:1639430770
Name:CAIN, JOAN BLACK (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:BLACK
Last Name:CAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2936 REDMONT PARK LN
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-2136
Mailing Address - Country:US
Mailing Address - Phone:205-322-3696
Mailing Address - Fax:205-716-1215
Practice Address - Street 1:2936 REDMONT PARK LN
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2136
Practice Address - Country:US
Practice Address - Phone:205-322-3696
Practice Address - Fax:205-716-1215
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL10162207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine