Individual
BRANDON S BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 896-9546
Mailing address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(504) 896-9546
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
022547
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04928847
—
MS
05
—
1560537
—
LA
Enumeration date
10/04/2006
Last updated
07/09/2007
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