CHARLES L. BLACK JR MD SURGICAL CLINIC CORP

SHREVEPORT, LA
NPI1952442832
Entity TypeOrganization
Authorized ContactCHARLES LESTER BLACK
Owner
318-221-0166
Organization Subpart ?No
Primary Taxonomy208600000X Surgery
(Licence: LA  011576)
Enumeration Date2007-02-12
Last Update Date2007-09-14
Business Address
CHARLES L. BLACK JR MD SURGICAL CLINIC CORP
1534 ELIZABETH AVE SUITE 202
SHREVEPORT, LA 71101-4516
Phone number: 318-221-0166
Mailing Address
CHARLES L. BLACK JR MD SURGICAL CLINIC CORP
1534 ELIZABETH AVE SUITE 202
SHREVEPORT, LA 71101-4516
Phone number: 318-221-0166
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