Individual
TIMOTHY E BLACK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 S DOBSON ROAD, SUITE 203, MESA, AZ 85202
(480) 844-7100
(480) 512-5486
Mailing address
PO BOX 29338, DEPT 1014, PHOENIX, AZ 85038
(480) 844-7100
(480) 512-5486
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17223
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273673
—
AZ
Enumeration date
03/24/2006
Last updated
07/08/2007
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