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Deactivated NPI 1346247640 Deactivated / Inactive NPI Male Practitioner

Dr. Clyde Edward Black , MD

Specialist • Anniston, AL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Clyde Black has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 30, 2005
NPI Deactivation Date March 08, 2023
Total Practice Duration ~18 Years of Practice (2005 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Clyde Black, MD was a registered Specialist practicing in Anniston, AL. Throughout an active medical career spanning 18 years, Dr. Black provided care at the practice location at 425 E 10TH ST until profile deactivation on 2023-03-08.

Practice Location & Contact Primary Location

Practice Address

425 E 10th St
Suite B

Anniston, AL 362074787

Telephone 2562363485
Fax 2562373787
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Anniston, AL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 38.9 Yrs
State Avg: 34.8 Yrs
Regional Practice Density
37 Specialists

Practicing in Anniston, AL (611 Statewide)

Telehealth Adoption Rate
2.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License AL 5174

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1104823392

Doctor of Medicine (M.D.)

NPI 1104823467

Doctor of Medicine (M.D.)

NPI 1649277575

Doctor of Medicine (M.D.)

NPI 1780681072

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 08, 2023

Record deactivated on March 08, 2023

NPI Profile Active March 17, 2008

NPI status registered as active in NPPES database

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Updated Practice Location March 17, 2008

Registered at 425 E 10TH ST, SUITE B, ANNISTON, AL 362074787 (Tel: 2562363485)

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Updated Business Mailing Address March 17, 2008

Registered at 425 E 10TH ST, SUITE B, ANNISTON, AL 362074787 (Tel: 2562363485)

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Provider Name / Credentials Updated March 17, 2008

Recorded as CLYDE BLACK, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2008

Specialist (License #5174 in AL)

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Initial NPI Registration & Enumeration June 30, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1346247640
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 30, 2005
Last Update: March 17, 2008
Deactivation Date: March 08, 2023

Mailing Address

425 E 10th St, Suite B

Anniston, AL 362074787

Phone: 2562363485

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.