Individual
CHARLES LAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1125 MARGUERITE ST, MORGAN CITY, LA 70380-1855
(985) 384-2200
Mailing address
PO BOX 2639, SAN ANTONIO, TX 78299-2639
(337) 824-4403
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD01919R
LA
Other
Enumeration date
07/16/2006
Last updated
07/08/2007
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