Black, Bradley C

Black, Bradley C is an individual health care provider with primary practice located at 5220 Flanders Dr , Baton Rouge LA 70808-9157. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Black, Bradley C can be contacted via phone (225) 766-3437.

Contact Information

Primary practice address
5220 Flanders Dr Baton Rouge LA 70808-9157
Phone: (225) 766-3437
Fax: (225) 766-3443
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 011988 Louisiana

Profile Details

NPI number 1861541575
LBN Legal business name Black, Bradley C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2007
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1861541575 NPPES
Louisiana MEDICAID 1323471

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