Individual
DR. CHARLES LAMAR NAUSE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
110 E MARKET ST, GREENWOOD, MS 38930-4430
(662) 453-5460
(662) 453-5551
Mailing address
110 E MARKET ST, PO BOX 1380, GREENWOOD, MS 38930-4430
(662) 453-5460
(662) 453-5551
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11262
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00016402
—
MS
Enumeration date
09/16/2005
Last updated
03/29/2017
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