Individual
CHARLES A. FEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 556-2300
(417) 556-3625
Mailing address
100 MERCY WAY, JOPLIN, MO 64804-4524
(417) 556-2300
(417) 556-3625
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R8J05
MO
207Q00000X
Family Medicine Physician
R8J05
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100113400A
—
OK
05
—
100234560E
—
KS
05
—
242744415
—
MO
Enumeration date
06/01/2006
Last updated
04/09/2015
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