Individual
DOUGLAS BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4300 S I 10 SERVICE RD W, METAIRIE, LA 70001-7405
(504) 301-9990
Mailing address
6237 WAINWRIGHT DR, NEW ORLEANS, LA 70122-3515
(504) 296-0349
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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