MICHAEL JASON BLACK

APPLETON, WI
NPI1720036387
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: WI  46688-020)
Additional Taxonomies208600000X Surgery
(Licence: WI  46688)
Enumeration Date2006-05-05
Last Update Date2025-07-22
Business Address
MICHAEL JASON BLACK M.D.
2000 E MILESTONE DR
APPLETON, WI 54913-6701
Phone number: 920-731-8131
Mailing Address
MICHAEL JASON BLACK M.D.
2000 E MILESTONE DR
APPLETON, WI 54913-6701
Phone number: 920-731-8131