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1710970330
FRED BLACK MD PC
ROSEBURG, OR
NPI
1710970330
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Entity Type
Organization
Authorized Contact
FREDERICK J BLACK
President
541-672-0497
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: OR MD10476)
Enumeration Date
2005-08-30
Last Update Date
2011-11-21
Business Address
FRED BLACK MD PC
2282 NW TROOST ST SUITE 103
ROSEBURG, OR 97471-6071
Phone number: 541-672-0497
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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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