Individual
CURTIS LEGRAND BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1219 APPLEGATE ST, PHILOMATH, OR 97370-2031
(541) 929-2922
Mailing address
1219 APPLEGATE ST, PO BOX 460, PHILOMATH, OR 97370-2031
(541) 929-2922
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
166825
OR
207Q00000X
Family Medicine Physician
59668451205
UT
Other
Enumeration date
03/30/2007
Last updated
06/25/2014
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