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Contact Information

BRADLEY C BLACK, MD
5220 FLANDERS DR
BATON ROUGE, LA70808-9157
 Phone: 225-766-3437
 Fax: 225-766-3443
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for BRADLEY C BLACK · (Male)

NPI Number 1861541575
Status Active
Credentials MD
Entity Individual
Enumeration date 01/10/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 011988
  • LA Medicaid 1323471
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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