Provider Demographics
NPI:1780686923
Name:JOINER, CHARLES RAY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:RAY
Last Name:JOINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3425 NORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3676
Mailing Address - Country:US
Mailing Address - Phone:318-442-2339
Mailing Address - Fax:318-442-2340
Practice Address - Street 1:3425 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3676
Practice Address - Country:US
Practice Address - Phone:318-442-2339
Practice Address - Fax:318-442-2340
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05712R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1321559Medicaid
LA52008DC43Medicare PIN
LAB63527Medicare UPIN