# CHARLES J ASWELL III MD A PROF MEDICAL CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104939099
- **Authorized official:** DR. CHARLES JESSE ASWELL III MD (OWNER)
- **Authorized official phone:** (337) 363-7474

## Contact information

- **Practice address:** 503 JACK MILLER ROAD, STE A, VILLE PLATTE, LA 70586
- **Practice address phone:** (337) 363-7474
- **Practice address fax:** (337) 363-1197
- **Mailing address:** 503 JACK MILLER ROAD, STE A, VILLE PLATTE, LA 70586
- **Mailing address phone:** (337) 363-7474
- **Mailing address fax:** (337) 363-1197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 12/07/2010