Individual provider · Type 1 NPI

Carl Black Jr., PA-C

Medical Physician Assistant · Philadelphia, PA

NPI number 1336723840 Active

Practice location

1216 E Hunting Park Ave
Philadelphia, PA 19124-4928

Call (215) 533-1333 Map

Fax (215) 744-4324

Other practice locations

  • 1909 E Washington Ln, Philadelphia, PA 19138-1229 · (215) 549-5900

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XOA005627 (PA)

Medical Physician Assistant: Definition to come...

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About NPI 1336723840

Carl Black Jr., PA-C's National Provider Identifier is 1336723840, issued on May 11, 2021. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Philadelphia, PA. The record was last updated on May 11, 2021.