Provider Demographics
NPI:1780666362
Name:BLACK, JAMES F (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:BLACK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:312 E MAIN ST
Mailing Address - Street 2:SUITE 2300 MARSHALLTOWN ANESTHESIOLOGISTS PLC
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-1888
Mailing Address - Country:US
Mailing Address - Phone:641-752-7149
Mailing Address - Fax:641-752-6320
Practice Address - Street 1:312 E MAIN ST
Practice Address - Street 2:SUITE 2300 MARSHALLTOWN ANESTHESIOLOGISTS PLC
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-1888
Practice Address - Country:US
Practice Address - Phone:641-752-7149
Practice Address - Fax:641-752-6320
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IA21955207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA171199Medicaid
IA41906OtherWELLMARK BCBS OF IA
A005OtherTRIWEST
IAIA0101OtherJOHN DEERE HEALTH
IAIA0101OtherJOHN DEERE HEALTH
IA41906Medicare ID - Type Unspecified