Individual
DR. CHARLES STEWART GREESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6300 MAIN ST, ZACHARY, LA 70791-4037
(225) 658-4000
(225) 763-9997
Mailing address
PO BOX 84110, BATON ROUGE, LA 70884-4110
(225) 675-8363
(225) 675-8364
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
010621
LA
2085R0202X
Diagnostic Radiology Physician
Primary
010621
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1301337
—
LA
Enumeration date
05/19/2006
Last updated
05/17/2021
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