Individual
ERNEST CHARLESWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 E BEAUREGARD AVE, SAN ANGELO, TX 76903-5919
(325) 481-2294
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 481-2294
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
D8172
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125204102
—
TX
Enumeration date
06/01/2005
Last updated
01/16/2013
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