Fred Black Md Pc in Roseburg - Family Medicine
Fred Black Md Pc - NPI 1710970330
Fred Black Md Pc is a Family Medicine in Roseburg, Oregon. Fred Black Md Pc practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Fred Black Md Pc is 1710970330. The last update date is 2011-11-21.
Fred Black Md Pc's current location address is 2282 Nw Troost St, Roseburg, Oregon. You can contact this provider via phone number 5416720497 and fax number 5419572663. The mailing address for Fred Black Md Pc is 2282 Nw Troost St, Roseburg, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Fred Black Md Pc |
|---|---|
| Address | 2282 Nw Troost St, Roseburg, Oregon |
| Phone Number | 5416720497 |
| Fax Number | 5419572663 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Black J Frederick |
| Credentials | MD |
| Telephone Number | 5416720497 |
NPI Number Detail
| NPI Number | 1710970330 |
|---|---|
| Provider Enumeration Date | 2005-08-30 |
| Last Updated Date | 2011-11-21 |
Provider Mailing Address Detail
| Address | 2282 Nw Troost St |
|---|---|
| City | Roseburg |
| State | Oregon (OR) |
| Post Code | 974716071 |
| Phone Number | 5416720497 |
| Fax Number | 5419572663 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | MD10476 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 218557 | OR | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Fred Black Md Pc by the Centers for Medicare & Medicaid Services?
The Fred Black Md Pc has been issued the NPI (National Provider Identifier) 1710970330, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Fred Black Md Pc?
The Fred Black Md Pc is situated at 2282 Nw Troost St, in the city of Roseburg, state of OR, with the zip code 974716071.
What is Fred Black Md Pc's area of expertise and its corresponding taxonomy classification?
The Fred Black Md Pc's field of specialization is Family Medicine, and it falls under the taxonomy code 207Q00000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1710970330 to Fred Black Md Pc?
The Centers for Medicare & Medicaid Services originally issued the 1710970330 to Fred Black Md Pc on 2005-08-30.
As of what date were the details related to Fred Black Md Pc most recently updated or revised?
The information pertaining to Fred Black Md Pc, including its address, specialty, and other relevant details, was last updated or revised on 2011-11-21.
NPI Number: 1588667679
Address: 9104 Babcock Blvd, Pittsburgh, PA