Black, Timothy E
Black, Timothy E is an individual health care provider with primary practice located at 1500 S Dobson Road Suite 203, Mesa AZ 85202. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Black, Timothy E can be contacted via phone (480) 844-7100.Contact Information
Primary practice address
1500 S Dobson Road Suite 203
Mesa AZ 85202
Phone: (480) 844-7100
Fax: (480) 512-5486
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 17223 | Arizona |
Profile Details
| NPI number | 1043270978 |
|---|---|
| LBN Legal business name | Black, Timothy E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043270978 | NPPES |
| Arizona | MEDICAID | 273673 |
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