Black, Charles

Black, Charles is an sole proprietor health care provider with primary practice located at 1534 Elizabeth Ave Suite 202, Shreveport LA 71101-4516. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Black, Charles can be contacted via phone (318) 681-7350.

Contact Information

Primary practice address
1534 Elizabeth Ave Suite 202 Shreveport LA 71101-4516
Phone: (318) 681-7350
Fax: (318) 681-7351
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X L011576 Louisiana

Profile Details

NPI number 1992744981
LBN Legal business name Black, Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 5th, 2006
Last updated Sep 14th, 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 1992744981 NPPES
Louisiana MEDICAID 1169838

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