Individual
DR. KIMBERLY G BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10240 PARK MEADOWS DR, LONE TREE, CO 80124-5425
(303) 338-4545
Mailing address
10350 E DAKOTA AVE, DENVER, CO 80247-1314
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A107360
CA
208600000X
Surgery Physician
Primary
DR.0055768
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026664
KAISER COMMERCIAL NUMBER
CO
05
—
44972717
—
CO
Enumeration date
08/20/2009
Last updated
06/14/2021
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