Kelly Jane Black in Phoenix - Sports Medicine
Kelly Jane Black - NPI 1700096955
Kelly Jane Black is a Sports Medicine in Phoenix, Arizona. Kelly Jane Black practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Kelly Jane Black is 1700096955. The last update date is 2007-07-08.
Kelly Jane Black's current location address is 3119 E Puget Ave, Phoenix, Arizona. You can contact this provider via phone number 6024931626. The mailing address for Kelly Jane Black is 3119 E Puget Ave, Phoenix, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly Jane Black |
|---|---|
| Address | 3119 E Puget Ave, Phoenix, Arizona |
| Phone Number | 6024931626 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1700096955 |
|---|---|
| Provider Enumeration Date | 2007-05-23 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3119 E Puget Ave |
|---|---|
| City | Phoenix |
| State | Arizona (AZ) |
| Post Code | 850285328 |
| Phone Number | 6024931626 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Ps0010X |
| Licence No | 24733 |
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Definition: An emergency physician with special knowledge in sports medicine is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention and management of injury and illness. |
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Post Comment/ Review Below
What is the Kelly Jane Black's 1700096955?
The Kelly Jane Black's NPI (National Provider Identifier) Number is 1700096955. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Kelly Jane Black's physical address?
The Kelly Jane Black is physically located at 3119 E Puget Ave, in the city of Phoenix, AZ, with the postal code 850285328.
What is Kelly Jane Black's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kelly Jane Black's area of specialization is Sports Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Ps0010X.
On what date did the Centers for Medicare & Medicaid Services issue the 1700096955 to Kelly Jane Black?
The Kelly Jane Black received its 1700096955 assignment from the Centers for Medicare & Medicaid Services on 2007-05-23.
When was the information pertaining to Kelly Jane Black most recently updated or revised?
The details related to Kelly Jane Black, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.
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