Black, Brandon R
Black, Brandon R is an individual health care provider with primary practice located at 1619 N Greenwood St Suite 103, Pueblo CO 81003-2644. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Black, Brandon R can be contacted via phone (719) 542-2167.Contact Information
Primary practice address
1619 N Greenwood St Suite 103
Pueblo CO 81003-2644
Phone: (719) 542-2167
Fax: (719) 542-0320
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 2001015984 | Missouri |
Profile Details
| NPI number | 1740249879 |
|---|---|
| LBN Legal business name | Black, Brandon R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 18th, 2006 |
| Last updated | Feb 9th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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