DR. CHARLES BLACK (NPI# 1992744981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992744981 |
| Entity Type | Individual |
| Full Name | DR. CHARLES BLACK |
| Other Name | DR. CHARLES BLACK |
| Credential | M.D. |
| Practice Address |
1534 Elizabeth Ave Suite 202 Shreveport LA 71101-4516 |
| Practice Telephone | 3186817350 |
| Practice Fax Number | 3186817351 |
| Mailing Telephone | 3186817350 |
| Mailing Fax Number | 3186817351 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2007-09-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | L011576 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1169838 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205094240 | Charles Randall Black | Dentist | 26 Long Pond Road, Plymouth County Correctional Facility, Plymouth, MA 02360-2606 | 2008-05-27 |
| 1962555342 | Charles Leonard Black | Emergency Medicine | 7600 General Motors Blvd, Medical Department, Shreveport, LA 71129-9426 | 2007-01-19 |
| 1356407902 | Charles Brad Black | Family Medicine | 214 E 3rd St, Libby, MT 59923-2056 | 2006-12-28 |
| 1053424234 | Charles Glenn Black | Physical Therapist | 1231 Colonial Park Dr, Severn, MD 21144-4417 | 2006-08-15 |
| 1528049723 | Charles Thomas Black | Surgery | 12200 Park Central Dr Ste 400, Dallas, TX 75251-2116 | 2005-11-07 |
| 1972754950 | Charles Black IIi | Dentist | 4728 Airport Blvd, Suite C, Mobile, AL 36608 | 2008-10-08 |
| 1790988087 | Charles Henry Black Iv | Orthopaedic Surgery | 1002 Jefferson St., Suite 350, Laurel, MS 39440-4306 | 2007-06-06 |
| 1427196096 | Charles Alexander Black Jr. | Technician, Other | 427 Commercial St, Boston, MA 02109-1027 | 2007-02-03 |
| 1497764187 | Charles B Black | Surgery | 1010 Three Springs Blvd, Durango, CO 81301-8296 | 2006-08-05 |
| 1730111378 | Charles Joseph Black | Social Worker | 4355 Ferguson Dr, Suite 270, Cincinnati, OH 45245-5136 | 2006-07-06 |
| Street Address |
1534 ELIZABETH AVE SUITE 202 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184663171 | Stephanie Barnes | Internal Medicine | 1534 Elizabeth Ave, Shreveport, LA 71101-4516 | 2006-06-05 |
| 1649670613 | Kandyce Lewis | Massage Therapist | 1534 Elizabeth Ave, #206, Shreveport, LA 71101-4516 | 2014-08-27 |
| 1952442832 | Charles L. Black Jr Md Surgical Clinic Corp | Surgery | 1534 Elizabeth Ave, Suite 202, Shreveport, LA 71101-4516 | 2007-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730663907 | Ida Molavi | Surgery | Department of Surgery, 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2018-09-24 |
| 1962500850 | Minimally Invasive Surgery Center of Louisiana | Surgery | 1534 Elizabeth Ave Ste 400, Shreveport, LA 71101-4531 | 2006-09-21 |
| 1104846989 | Kevin Mark Sittig | Surgery | 1541 Kings Hwy Dept Of, Shreveport, LA 71103-4228 | 2006-07-21 |
| 1285670356 | George Robert Merriman II | Surgery | 949 Olive St, Shreveport, LA 71104-2103 | 2006-06-20 |
| 1417900416 | Milon G Karmakar | Surgery | 3300 Albert L Bicknell Dr, Suite 6, Shreveport, LA 71103-3903 | 2006-05-18 |
| 1821054214 | John Davidson Gladney | Surgery | 8001 Youree Drive, Suite 840, Shreveport, LA 71115-2302 | 2006-04-25 |
| 1801890769 | F Dean Griffen | Surgery | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2005-06-09 |
| 1053315903 | James Booth Burke | Surgery | 1202 Louisiana Avenue, Shreveport, LA 71101-3910 | 2005-06-09 |
| 1760486609 | William Lewis Norwood Jr. | Surgery | 2751 Albert Bicknell Drive, Suite 3a, Shreveport, LA 71103-3976 | 2005-06-09 |
| 1619588019 | Wk Minimally Invasive Surgery Center | Surgery | 2751 Albert L Bicknell Dr Ste 3a, Shreveport, LA 71103-3976 | 2020-08-11 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
Please comment or provide details below to improve the information on DR. CHARLES BLACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.