Individual
KATHRYN B BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1615 DELAWARE ST, ANES. DEPT, LONGVIEW, WA 98632-2310
(360) 425-7280
Mailing address
804 SCOTT NIXON MEMORIAL DR, AUGUSTA, GA 30907-2464
(800) 394-4445
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00023593
WA
Other
Enumeration date
11/30/2005
Last updated
10/22/2007
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