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Individual

DR. CARLTON WAYNE HERALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5533
(740) 441-3318
Mailing address
PO BOX 1680, HUNTINGTON, WV 25717-1680
(304) 697-1396
(304) 697-2086

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34.007166
OH
207R00000X
Internal Medicine Physician
1984
WV
207R00000X
Internal Medicine Physician
Primary
34.007166
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00427029
RR MEDICARE
WV
05
2005609000
WV
05
2168890
OH
05
64071467
KY
Enumeration date
11/02/2005
Last updated
07/21/2022
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