Teagle, Clarence Raphiel
Teagle, Clarence Raphiel is an individual health care provider with primary practice located at 8001 Youree Dr Suite 450, Shreveport LA 71115-2302. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Teagle, Clarence Raphiel can be contacted via phone (318) 212-3952.Contact Information
Primary practice address
8001 Youree Dr Suite 450
Shreveport LA 71115-2302
Phone: (318) 212-3952
Fax: (318) 212-3955
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 009465 | Louisiana |
Profile Details
| NPI number | 1659302339 |
|---|---|
| LBN Legal business name | Teagle, Clarence Raphiel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Dec 5th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659302339 | NPPES |
| Louisiana | MEDICAID | 1097144 |
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