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CHARLES L. BLACK JR MD SURGICAL CLINIC CORP NPI 1952442832


NPI Information

NPI: 1952442832
Provider Name: CHARLES L. BLACK JR MD SURGICAL CLINIC CORP
Classification: Surgery - 208600000X
Entity Type: Organization
Address:
1534 ELIZABETH AVE
SUITE 202
SHREVEPORT, LA
ZIP 71101
Phone: (318) 221-0166
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CHARLES L. BLACK JR MD SURGICAL CLINIC CORP is a surgery in Shreveport, LA. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. CHARLES L. BLACK JR MD SURGICAL CLINIC CORP NPI is 1952442832. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1534 ELIZABETH AVE
SUITE 202
SHREVEPORT, LA
ZIP 71101-516
Phone: (318) 221-0166

The provider's authorized official is Charles Lester Black .
The authorized official title is Owner and has the following contact phone number (318) 221-0166.

The enumeration date for this NPI number is 2/12/2007 and was last updated on 9/14/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgery011576LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15CJ93MEDICARE ID-TYPE UNSPECIFIEDLOUISIANA
2B62288MEDICARE UPIN
31169838MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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