FRED BLACK MD PC

ROSEBURG, OR
NPI1710970330
Entity TypeOrganization
Authorized ContactFREDERICK J BLACK
President
541-672-0497
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: OR  MD10476)
Enumeration Date2005-08-30
Last Update Date2011-11-21
Business Address
FRED BLACK MD PC
2282 NW TROOST ST SUITE 103
ROSEBURG, OR 97471-6071
Phone number: 541-672-0497
Mailing Address
FRED BLACK MD PC
2282 NW TROOST ST SUITE 103
ROSEBURG, OR 97471-6071
Phone number: 541-672-0497
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