IndividualActive
Carl Black, MD
NPI 1891737094 · Diagnostic Radiology Physician · Provo, UT
Provider details
- NPI number
- 1891737094
- Entity type
- Individual
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 4737479-1205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1034 N 500 W
Provo, UT 84604-3380
Phone: (801) 357-4423
Fax: (801) 357-7626
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 30180
Salt Lake City, UT 84130-0180
Registry dates
- Enumerated
- 2006-06-12
- Last updated
- 2026-06-05
- Certified
- 2026-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.