Individual
DR. CHARLES D MABRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1609 W 40TH AVE STE 403, PINE BLUFF, AR 71603-6365
(870) 535-8280
(870) 535-5458
Mailing address
PO BOX 2650, PINE BLUFF, AR 71613-2650
(870) 541-7211
(870) 541-4297
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
C4953
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104825001
—
AR
Enumeration date
10/07/2005
Last updated
10/11/2023
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