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Individual

DR. CHARLES B BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1010 THREE SPRINGS BLVD, DURANGO, CO 81301-8296
(970) 247-4311
Mailing address
1010 THREE SPRINGS BLVD, DURANGO, CO 81301-8296
(970) 247-4311

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
42300
WI
208600000X
Surgery Physician
DR.0051621
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
33341000
WI
Enumeration date
08/05/2006
Last updated
03/07/2023
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