Individual
DR. ELLIOTT BUNYAN BLACK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4228 HOUMA BLVD, SUITE 100, METAIRIE, LA 70006-3000
(504) 883-8900
(504) 883-8901
Mailing address
4228 HOUMA BLVD, SUITE 100, METAIRIE, LA 70006-3000
(504) 883-8900
(504) 883-8901
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
011207
LA
Other
Enumeration date
09/25/2006
Last updated
07/08/2007
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