person
Beau Stephen Black, MD
Student in an Organized Health Care Education/Training Program in Baton Rouge, Louisiana
NPI 1568621472

Beau Stephen Black is a Student in an Organized Health Care Education/Training Program based in Baton Rouge, LA. Beau Stephen Black practices in Baton Rouge, LA and has the professional credentials of MD. The NPI Number for Beau Stephen Black is 1568621472 and holds a License No. MD.203055 (Louisiana).

The current practice location address for Beau Stephen Black is 5000 Hennessy Blvd, Baton Rouge, LA and can be reached out via phone at 225-757-0552 and via fax at 225-763-9997. You can also correspond with Beau Stephen Black through the mailing address at 8230 SUMMA AVE STE C, BATON ROUGE, LA - 70809-3465 (mailing address contact number: 225-757-0552).

Location: 5000 Hennessy Blvd, Baton Rouge, LA, 70809-3465
person
Provider Profile Details
NPI Number
1568621472
Provider Name
Beau Stephen Black
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
5000 Hennessy Blvd, Baton Rouge, LA, 70809-3465
Phone Number
225-757-0552
Fax Number
225-763-9997
Provider Enumeration Date
06/05/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1084484 05 LA
institution
Provider Business Practice Location Address Details
Address
5000 Hennessy Blvd
City
State
Zip
70808-4375
Phone Number
225-757-0552
Fax Number
225-763-9997
person
Provider Business Mailing Address Details
Address
8230 Summa Ave Ste C
City
State
Zip
70809-3465
Phone Number
225-757-0552
Fax Number
225-763-9997
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
License No.
()
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
MD.203055 (Louisiana)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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