Individual
DR. BRADLEY C BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5220 FLANDERS DR, BATON ROUGE, LA 70808-9157
(225) 766-3437
(225) 766-3443
Mailing address
5220 FLANDERS DR, BATON ROUGE, LA 70808-9157
(225) 766-3437
(225) 766-3443
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
011988
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1323471
—
LA
Enumeration date
01/10/2007
Last updated
07/08/2007
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