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Organization

R CHARLES MEDLAR, MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT CHARLES MEDLAR (PRESIDENT)
(517) 787-4470
Entity
Organization

Contact information

Practice address
150 S EAST AVE, JACKSON, MI 49201-2412
(517) 787-3902
(517) 787-8335
Mailing address
PO BOX 600, JACKSON, MI 49204-0600
(517) 787-3902
(517) 787-8335

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
36871
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0380001
BCBS MI
05
1327328
MI
Enumeration date
04/29/2008
Last updated
01/04/2010
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