| Daniel R Black, DO | |
|
100 Jackson Pike, Gallipolis, OH 45631-1560 | |
| (740) 446-5401 | |
| (740) 446-5408 |
| Full Name | Daniel R Black |
|---|---|
| Gender | Male |
| Speciality | Physical Medicine And Rehabilitation |
| Experience | 40 Years |
| Location | 100 Jackson Pike, Gallipolis, Ohio |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598719882 | NPI | - | NPPES |
| 000000185253 | Other | OH | UNISON MEDICAID |
| 310917085122 | Other | OH | CARESOURCE MEDICAID |
| 200013580 | Other | RR MEDICARE | |
| 000000006573 | Other | ANTHEM BCBS | |
| 0113223000 | Medicaid | WV | |
| 0749373 | Medicaid | OH | |
| 001714051 | Other | MOUNTAIN STATE BCBS | |
| 0749373 | Other | OH | MOLINA MEDICAID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 34-00-4704 (Ohio) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Holzer Clinic Llc | 5890606008 | 264 |
| Entity Name | Holzer Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508817248 PECOS PAC ID: 5890606008 Enrollment ID: O20031215000746 |
| Mailing Address | Practice Location Address |
|---|---|
| Daniel R Black, DO 90 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5401 | Daniel R Black, DO 100 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5401 |
Shailen K. Mehta, M.D. Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 90 Jackson Pike, Gallipolis, OH 45631 Phone: 740-441-8070 Fax: 740-446-5408 | |
Dr. Corey Allen Johnson, D.O. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 855-446-5937 Fax: 740-446-5408 |