Robert Lee Black III, PA-C
Physician Assistant, Medical in Meadville, PA. Individual provider (NPI-1).
NPI number1861985657
StatusActive
Last updated in NPPESApr 1, 2025
Details
- NPI
- 1861985657
- Entity type
- Individual (NPI-1)
- Name
- Robert Lee Black III
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 7, 2018
- Certification date
- Apr 1, 2025
- Last updated
- Apr 1, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | – | Yes |
| 363A00000X | Physician Assistant | – | – |
Practice location
640 Alden StMeadville, PA 16335-2348
Phone 814-373-5255 · Fax 814-373-5259
Mailing address
1034 Grove StMeadville, PA 16335-2945
Phone 814-373-5266 · Fax 814-373-5269
Other practice locations
18201 Conneaut Lake Rd
Meadville, PA 16335-3757
Meadville, PA 16335-3757
Phone 814-333-5061 · Fax 814-333-5067
406 W Oak St
Titusville, PA 16354-1499
Titusville, PA 16354-1499
Phone 814-827-9770
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