Individual
JOSEPH M BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M D
Contact information
Practice address
2550 NW EDENBOWER BLVD, SUITE 100, ROSEBURG, OR 97471-8829
(541) 580-5328
(541) 727-5360
Mailing address
2550 NW EDENBOWER BLVD, SUITE 100, ROSEBURG, OR 97471-8829
(541) 580-5328
(541) 727-5360
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD20220
OR
208M00000X
Hospitalist Physician
MD20220
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151095
—
OR
Enumeration date
03/31/2006
Last updated
03/03/2015
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