Black, Kelly Jane

Black, Kelly Jane is an individual health care provider with primary practice located at 4530 N 32Nd St Ste 102 , Phoenix AZ 85018-3357. She recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as her primary health care specialty. Black, Kelly Jane can be contacted via phone (602) 493-1626.

Contact Information

Primary practice address
4530 N 32Nd St Ste 102 Phoenix AZ 85018-3357
Phone: (602) 493-1626
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207PS0010X 24733 Arizona

Profile Details

NPI number 1700096955
LBN Legal business name Black, Kelly Jane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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