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Kenneth A Black, MD
Family Medicine Physician in Portage, Indiana
NPI 1134184112

Kenneth A Black is a Family Medicine Physician based in Portage, IN. Kenneth A Black practices in Portage, IN and has the professional credentials of MD. The NPI Number for Kenneth A Black is 1134184112 and holds a License No. 01024841 (Indiana).

The current practice location address for Kenneth A Black is 3630 Willowcreek Rd, Portage, IN and can be reached out via phone at 219-759-1157.

Location: 3630 Willowcreek Rd, Portage, IN, 46368-5075
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1134184112
Provider Name
Kenneth A Black
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
3630 Willowcreek Rd, Portage, IN, 46368-5075
Phone Number
219-759-1157
Fax Number
Provider Enumeration Date
04/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100207860A 05 IN
000000521738 01 IN ANTHEM
5251392 01 AETNA
institution
Provider Business Practice Location Address Details
Address
3630 Willowcreek Rd
City
Portage
State
Indiana
Zip
46368-5075
Phone Number
219-759-1157
Fax Number
person
Provider Business Mailing Address Details
Address
3630 Willowcreek Rd
City
Portage
State
Indiana
Zip
46368-5075
Phone Number
219-759-1157
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
01024841 (Indiana)
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.
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