Black, Charles Henry

Black, Charles Henry is an sole proprietor health care provider with primary practice located at 1002 Jefferson St. Suite 350, Laurel MS 39440-4306. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Black, Charles Henry can be contacted via phone (601) 649-5990.

Contact Information

Primary practice address
1002 Jefferson St. Suite 350 Laurel MS 39440-4306
Phone: (601) 649-5990
Fax: (601) 425-7510
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 5101016776 Michigan
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 23113 Mississippi

Profile Details

NPI number 1790988087
LBN Legal business name Black, Charles Henry
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2007
Last updated Jan 6th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790988087 NPPES
Mississippi MEDICAID 08107236

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