| Mary Black Physicians Group Llc | |
|
130 Dillon Dr Spartanburg SC 29307-1018 | |
| (864) 585-2027 | |
| (864) 585-2488 |
| Full Name | Mary Black Physicians Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 130 Dillon Dr, Spartanburg, South Carolina |
| Authorized Official Name and Position | Sophia L Arwood (DIRECTOR) |
| Authorized Official Contact | 6156286038 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Black Physicians Group Llc Po Box 689022 Provider Enrollment Department Franklin TN 37068-9022 Ph: (615) 465-7000 | Mary Black Physicians Group Llc 130 Dillon Dr Spartanburg SC 29307-1018 Ph: (864) 585-2027 |
| NPI Number | 1295823045 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 01/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295823045 | NPI | - | NPPES |
| GP4690 | Medicaid | SC |
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