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Organization

CHARLES J ASWELL III MD A PROF MEDICAL CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES JESSE ASWELL III MD (OWNER)
(337) 363-7474
Entity
Organization

Contact information

Practice address
503 JACK MILLER ROAD, STE A, VILLE PLATTE, LA 70586
(337) 363-7474
(337) 363-1197
Mailing address
503 JACK MILLER ROAD, STE A, VILLE PLATTE, LA 70586
(337) 363-7474
(337) 363-1197

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1104939099
ORGANIZATION NPI
LA
05
1188531
LA
01
1801842141
INDIVIDUAL NPI
Enumeration date
08/16/2006
Last updated
12/07/2010
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