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Contact Information

MICHAEL T BLACK
317 LAD LN
ROSEBURG, OR97471-4420
 Phone: 541-393-4138
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Attendant Care Provider

3747A0650X
Indicates primary specialty

NPI Profile & details for MICHAEL T BLACK · (Male)

NPI # 1316768872
Status Active
Credentials
Entity Individual
Enumeration date 10/17/2024
Last updated 10/17/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • OR License # 1922258
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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