Jeremy Taylor Black I
Jeremy Taylor Black I is a Student in an Organized Health Care Education/Training Program in Mobile, Alabama. Licensed in Oregon. Registered with an NPI since 2023.
- Licensed in
- OR
- In the registry since
- 2023
- Specialties on file
- 2
Practice location Address checks out
6517 Cedar Bend CtMobile, AL 36608-5333
Phone: (801) 842-1517
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence PA223011 (OR) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1457034191 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | August 9, 2023 |
| Last updated in NPPES | December 17, 2024 |
| Certification date | December 17, 2024 |
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