Individual
CHARLES M RICHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
155412
FL
208600000X
Surgery Physician
38595
GA
2086S0102X
Surgical Critical Care Physician
155412
FL
2086S0102X
Surgical Critical Care Physician
38595
GA
2086S0127X
Trauma Surgery Physician
155412
FL
2086S0127X
Trauma Surgery Physician
Primary
344494
LA
2086S0127X
Trauma Surgery Physician
38595
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102515706
—
TX
01
—
102515707
MEDICAID-CSHCN
TX
Enumeration date
06/06/2006
Last updated
02/06/2025
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