Individual
CHARLES J BRDLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 RYAN ST, SUITE 105, LAKE CHARLES, LA 70601-6078
(337) 439-4706
(337) 439-8110
Mailing address
1800 RYAN ST, SUITE 105, LAKE CHARLES, LA 70601-6078
(337) 439-4706
(337) 439-8110
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
07505R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1373231
—
LA
01
—
18606
CDS
LA
01
—
300083018
RAILROAD MEDICARE
—
Enumeration date
11/23/2005
Last updated
03/07/2023
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