Provider Demographics
NPI:1174551055
Name:SALE, CHARLES F (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:SALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8001 YOUREE DR.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-2302
Mailing Address - Country:US
Mailing Address - Phone:318-212-3800
Mailing Address - Fax:313-212-3805
Practice Address - Street 1:8001 YOUREE DR.
Practice Address - Street 2:SUITE 300
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-2302
Practice Address - Country:US
Practice Address - Phone:318-212-3800
Practice Address - Fax:318-212-3895
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA014790208D00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1329266Medicaid
LA5H887Medicare PIN
D04097Medicare UPIN
LA1329266Medicaid