Self, Charles Edward

Self, Charles Edward is an individual health care provider with primary practice located at 1111 Homer Rd , Minden LA 71055-3027. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Self, Charles Edward can be contacted via phone (318) 377-7500.

Contact Information

Primary practice address
1111 Homer Rd Minden LA 71055-3027
Phone: (318) 377-7500
Fax: (318) 377-2324
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA.A10425.RX Louisiana

Profile Details

NPI number 1497741995
LBN Legal business name Self, Charles Edward
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated Jul 9th, 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 1497741995 NPPES
Louisiana Other PA.A10425.RX LA STATE PA LICENSE

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