person
Mr. Charles Edward Self, PA-C
Medical Physician Assistant in Minden, Louisiana
NPI 1497741995

Charles Edward Self is a Medical Physician Assistant based in Minden, LA and is specialized in Medical. Charles Edward Self practices in Minden, LA and has the professional credentials of PA-C. The NPI Number for Charles Edward Self is 1497741995 and holds a License No. PA.A10425.RX (Louisiana).

The current practice location address for Charles Edward Self is 1111 Homer Rd, Minden, LA and can be reached out via phone at 318-377-7500 and via fax at 318-377-2324.

Location: 1111 Homer Rd, Minden, LA, 71055-1301
person
Provider Profile Details
NPI Number
1497741995
Provider Name
Charles Edward Self
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
1111 Homer Rd, Minden, LA, 71055-1301
Phone Number
318-377-7500
Fax Number
318-377-2324
Provider Enumeration Date
09/21/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PA.A10425.RX 01 LA LA STATE PA LICENSE
institution
Provider Business Practice Location Address Details
Address
1111 Homer Rd
City
State
Zip
71055-3027
Phone Number
318-377-7500
Fax Number
318-377-2324
person
Provider Business Mailing Address Details
Address
1111 Homer Rd
City
State
Zip
71055-3027
Phone Number
318-377-7500
Fax Number
318-377-2324
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA.A10425.RX (Louisiana)
Definition
Definition to come...
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