Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. TRACY REYMORE BLACK, PA-C
ActivePhysician Assistant · MYRTLE BEACH, SC
Registration Details
- NPI Number
- 1033181193
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Feb 3, 2006 (20.225234642796 yrs)
- Last Updated
- Dec 21, 2018
- License
-
101218 (NC)
Practice Information
- Address
-
8208 DEVON COURTSUITE BMYRTLE BEACH, SC, 29572Browse SC providers · Browse ZIP 29572
- Phone
- 7043646110
- Fax
- 7043644245
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in MYRTLE BEACH, SC
| Name | Credential | NPI |
|---|---|---|
| MRS. ASHLEY SMITH WILSON | P.A. | 1487655106 |
| RANDALL PAUL GROVE | PA | 1619969250 |
| MRS. ROBERTA RAE ALSWORTH | PA-C | 1790775385 |
| JOSEPH K BETHLE | PAC | 1235195850 |
| HISHAM IBRAHIM BASSIOUNI | PAC | 1205883105 |
| MR. JEFFREY THOMAS WEEDEN | P.A. | 1972539286 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.