Provider Demographics
NPI:1700916509
Name:BLACK, FRANKLIN OWEN (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:OWEN
Last Name:BLACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:F
Other - Middle Name:OWEN
Other - Last Name:BLACK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3950
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208
Mailing Address - Country:US
Mailing Address - Phone:503-233-6088
Mailing Address - Fax:503-233-8558
Practice Address - Street 1:1225 NE 2ND AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97208
Practice Address - Country:US
Practice Address - Phone:503-233-6068
Practice Address - Fax:503-233-8558
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD13135207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology