Individual
MR. CHARLES THOMAS INGRAM JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1077 S MAIN, MADISON, GA 30650
(706) 342-1667
Mailing address
PO BOX 72483, MARIETTA, GA 30007-2483
(770) 578-1800
(770) 578-6168
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
19704
GA
Other
Enumeration date
06/07/2006
Last updated
07/08/2007
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