Individual
DR. CHARLES D CESARE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1110 W KINGSHIGHWAY, PARAGOULD, AR 72450-4164
(870) 205-2000
(870) 205-2001
Mailing address
1000 W KINGSHIGHWAY STE 14, PARAGOULD, AR 72450-4197
(870) 239-8591
(870) 239-8137
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
9601
MS
207V00000X
Obstetrics & Gynecology Physician
Primary
E7806
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114569
—
MS
01
—
111171001
ARK MEDICAID
MS
05
—
111171001
—
AR
01
—
81301
ARK BCBS
MS
Enumeration date
09/21/2005
Last updated
12/02/2020
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