Dr. Derek Alan Black, O.D.
Optometrist in Cumming, GA. Individual provider (NPI-1).
NPI number1114353232
StatusActive
Last updated in NPPESOct 26, 2020
Details
- NPI
- 1114353232
- Entity type
- Individual (NPI-1)
- Name
- Dr. Derek Alan Black
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 20, 2013
- Certification date
- Oct 26, 2020
- Last updated
- Oct 26, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OPT002922 | GA | Yes |
Practice location
1211 Bald Ridge Marina RdCumming, GA 30041-8484
Phone 470-239-6625 · Fax 470-239-6626
Mailing address
1211 Bald Ridge Marina RdCumming, GA 30041-8484
Phone 470-239-6625 · Fax 470-239-6626
Other practice locations
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Optometrist providers in Cumming, GA
- Madalen Arzuaga, ODNPI 1659332583
- Ascending Sight, LLCNPI 1063221968
- John T Barker, O.D.NPI 1629111083
- Barker&Truong, O.D., P.C.NPI 1346532801
- Bharti Bathija-Lala, ODNPI 1336104330
- Scott Baylard, O.D.NPI 1255472916
- Bethelview Eyecare INCNPI 1932382942
- Krishan Raman Bhima, O.D.NPI 1215272232
- William C Bonner, ODNPI 1750309597
- Gina Borgnini, O.D.NPI 1124045893
All 59 Optometrist providers in Cumming · All 3,228 providers in Cumming
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.