Individual
DEBORAH J CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
902 N 7TH ST, CORDELE, GA 31015-3234
(229) 276-3356
(229) 276-3382
Mailing address
PO BOX 138, COLUMBUS, GA 31902-0138
(229) 276-3356
(229) 276-3382
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
028742
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000400562L
—
GA
Enumeration date
12/14/2005
Last updated
04/01/2010
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