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Individual

MR. CHARLES JAMES KISTLER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
421 GEORGESVILLE ROAD, COLUMBUS, OH 43228
(614) 272-7700
(614) 272-2728
Mailing address
421 GEORGESVILLE ROAD, COLUMBUS, OH 43228
(614) 272-7700
(614) 272-2728

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2242
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0411067
OH
01
35215824501
BLUE
OH
Enumeration date
01/30/2007
Last updated
04/24/2013
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