Individual
CHARLES E BLOODSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4200 HOUMA BLVD, METAIRIE, LA 70006-2970
(504) 779-5515
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(800) 242-1131
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
101632
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP05006
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1509043
—
LA
Enumeration date
11/29/2006
Last updated
12/06/2010
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