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Individual

MARK A BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 239-7667
Mailing address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 239-7667

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
253622
NY
207P00000X
Emergency Medicine Physician
Primary
ME-124249
FL

Other

Enumeration date
04/14/2008
Last updated
06/27/2024
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