Individual
MR. CHARLES NEAL THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5402 SUMMERHILL RD, TEXARKANA, TX 75503-4607
(903) 614-3937
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G7728
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109971001
—
AR
01
—
81380Y
TEXAS BLUE CROSS
TX
01
—
89553
AR BLUE CROSS
AR
Enumeration date
07/07/2005
Last updated
12/02/2011
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