Charles L. Black Jr Md Surgical Clinic Corp
LBN: Charles L. Black Jr Md Surgical Clinic Corp
Charles L. Black Jr Md Surgical Clinic Corp is an health care organization with primary practice located at 1534 Elizabeth Ave Suite 202, Shreveport LA 71101-4516. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as the primary health care specialty.
Charles L. Black Jr Md Surgical Clinic Corp can be contacted via phone (318) 221-0166, or through Black, Charles Lester via phone (318) 221-0166.
Contact Information
Primary practice address
1534 Elizabeth Ave Suite 202
Shreveport LA 71101-4516
Phone: (318) 221-0166
Fax:
Website:
Authorized official contact:
Name: Black, Charles Lester Doctor of Medicine (MD)
Phone: (318) 221-0166
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 011576 | Louisiana |
Profile Details
| NPI number | 1952442832 |
|---|---|
| LBN Legal business name | Charles L. Black Jr Md Surgical Clinic Corp |
| DBA Doing business as | |
| Authorized official | Black, Charles Lester Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 12th, 2007 |
| Last updated | Sep 14th, 2007 - about 19 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952442832 | NPPES |
| Louisiana | MEDICAID | 1169838 |
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