Fred Black Md Pc

LBN: Fred Black Md Pc
Fred Black Md Pc is an health care organization with primary practice located at 2282 Nw Troost St Suite 103, Roseburg OR 97471-6071. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Fred Black Md Pc can be contacted via phone (541) 672-0497, or through Black, Frederick J via phone (541) 672-0497.

Contact Information

Primary practice address
2282 Nw Troost St Suite 103 Roseburg OR 97471-6071
Phone: (541) 672-0497
Fax: (541) 957-2663
Website:
Map and Directions
Authorized official contact:
Name: Black, Frederick J Doctor of Medicine (MD)
Phone: (541) 672-0497

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD10476 Oregon

Profile Details

NPI number 1710970330
LBN Legal business name Fred Black Md Pc
DBA Doing business as
Authorized official Black, Frederick J Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 30th, 2005
Last updated Nov 21st, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710970330 NPPES
Oregon MEDICAID 218557

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