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FRED BLACK MD PC
NPI 1710970330
Family Medicine in Roseburg, OR

Active since August 30, 2005
2282 NW TROOST ST, SUITE 103, ROSEBURG, OR 97471(541) 672-0497(541) 957-2663 Get Directions Write a Review

NPPES record last updated: November 21, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Fred Black Md Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FRED BLACK MD PC (NPI 1710970330) is a healthcare organization registered as a family medicine in Roseburg, Oregon and active in the NPI registry since August 2005. The organization lists Frederick J Black, President, as its authorized official.

NPPES Registry Identity

NPI1710970330
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFRED BLACK MD PC
Location Address2282 NW TROOST ST, SUITE 103Roseburg, OR 97471-6071
Mailing Address2282 Nw Troost St, Suite 103Roseburg, OR 97471-6071 · (541) 672-0497 · Fax (541) 957-2663
Phone(541) 672-0497
Fax(541) 957-2663
Organization SubpartNo
Authorized OfficialFrederick J BlackPresident · (541) 672-0497
Enumeration DateAugust 30, 2005
Last NPPES UpdateNovember 21, 2011
✔ NPI 1710970330 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OR · MD10476
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2282 NW TROOST ST, Roseburg, OR 97471
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Other Identifiers 3

Medicaid218557OR
Medicare UPINC92226
Medicare PIN112030OR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. GERALD ANDREW JAWORSKI M.D.
Family Medicine
2282 NW TROOST ST, STE. 101
ROSEBURG, OR 97471
Douglas County (541) 673-0609

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fred Black MD PC's NPI number?

The NPI number for Fred Black MD PC is 1710970330. It was assigned to this organization in the NPPES registry on August 30, 2005.

Where is Fred Black MD PC located?

Fred Black MD PC is located at 2282 NW Troost St Suite 103, Roseburg, OR 97471. The listed phone number is (541) 672-0497.

What is Fred Black MD PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Fred Black MD PC was last updated on November 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.