Individual
DR. LOREN ORION BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MBA
Contact information
Practice address
6165 W EMERALD ST, BOISE, ID 83704-8613
(208) 302-3900
(208) 302-3955
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M-17771
ID
207X00000X
Orthopaedic Surgery Physician
MD61416009
WA
207XX0801X
Orthopaedic Trauma Physician
MD61416009
WA
Other
Enumeration date
03/27/2018
Last updated
07/09/2024
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