Most Relevant Information
Provider Data
| NPI Number: | 1003828534 |
| Provider Name: | ROBERT J BLACK OD |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 1201 |
Most Important Dates
| Enumeration Date: | 08/13/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
171 ASHLEY AVE
CHARLESTON
SC
294250001
Practice Location Phone/Fax
| Phone: | 8437921414 |
| Fax: |
Provider Mailing Location
PO BOX 751461
CHARLOTTE
NC
282751461
Provider Mailing Phone/Fax
| Phone: | 8437926200 |
| Fax: |