# DR. CHARLES HENRY TADLOCK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1861487878
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 26067 | AZ | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 5937479-1205 | UT | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 8402 | NV | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | G62878 | CA | — |

## Other

- **Enumeration date:** 09/15/2005
- **Last updated:** 10/19/2011