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1306062625
DESTIN R. BLACK
SHREVEPORT, LA
NPI
1306062625
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207VX0201X Obstetrics & Gynecology, Gynecologic Oncology
(Licence: LA 024725)
Enumeration Date
2007-04-17
Last Update Date
2021-06-18
Business Address
DESTIN R. BLACK MD
2600 KINGS HWY SUITE 420
SHREVEPORT, LA 71103-3950
Phone number: 318-212-8727
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Mailing Address
DESTIN R. BLACK MD
2600 KINGS HWY SUITE 420
SHREVEPORT, LA 71103-3950
Phone number: 318-212-8727
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