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
Fax: (318) 212-3955
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659302339 NPPES
Louisiana MEDICAID 1097144

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