Individual
DR. CHARLES RAY STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 BELLE CHASSE HIGHWAY, GRETNA, LA 70056
(504) 392-3131
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
020683
LA
207P00000X
Emergency Medicine Physician
Primary
MD.020683
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00607769
—
MS
05
—
1300390
—
LA
Enumeration date
07/10/2006
Last updated
12/17/2008
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