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Contact Information

GARY C BLACK, MD
9400 RHEA COUNTY HWY
DAYTON, TN37321
 Phone: 423-285-5220
 Fax: 423-285-5506
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for GARY C BLACK · (Male)

NPI # 1700149648
Status Active
Credentials MD
Entity Individual
Enumeration date 06/15/2012
Last updated 06/01/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • SC License # LL34886
  • TN License # 55829
  • TN Medicaid Q029957
  • TN Other T00148A MEDICARE PTAN
Hospital affiliation(s)
  • RHEA MEDICAL CENTER - (Critical Access)
    9400 RHEA COUNTY HIGHWAY
    DAYTON, TN 37321
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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