| |
2449 Sw 4th Ave, Ste 203, Ontario, OR 97914-1859 | |
(541) 889-8637 | |
(541) 889-4736 |
Full Name | |
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Type | Facility |
Speciality | Podiatrist |
Location | 2449 Sw 4th Ave, Ontario, Oregon |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780713552 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | DP00359 (Oregon) | Primary |
Mailing Address | Practice Location Address |
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1511 W Bonneville Ct, Nampa, ID 83686-9749 Ph: (208) 463-7732 | 2449 Sw 4th Ave, Ste 203, Ontario, OR 97914-1859 Ph: (541) 889-8637 |
Dr. Andrew P Black, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1050 Sw 3rd Ave Ste 400, Ontario, OR 97914 Phone: 541-881-1319 |