Individual
DEBORAH L BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2016 W 16TH ST, SAFFORD, AZ 85546-4026
(928) 428-1377
(928) 348-8570
Mailing address
2016 W 16TH ST, SAFFORD, AZ 85546-4026
(928) 428-1377
(928) 348-8570
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2394
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
636631
—
AZ
Enumeration date
11/08/2006
Last updated
07/08/2007
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