Individual
DR. CHARLES OTIS TUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 N LAFAYETTE ST, SUITE 01, SHELBY, NC 28150-4444
(704) 482-3880
(704) 487-0294
Mailing address
222 N LAFAYETTE ST, SUITE 01, SHELBY, NC 28150-4444
(704) 482-3880
(704) 487-0294
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
98-00721
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11349
NC BLUE CROSS BLUE SHIELD
NC
01
—
13103
SC MEDICAL LICENSE
SC
05
—
131039
—
SC
01
—
19736
OKLAHOMA MEDICAL LICENSE
OK
05
—
8911349
—
NC
01
—
98-00721
NC MEDICAL LICENSE
NC
01
—
MD0000019644
TENNESSEE MEDICAL LICENSE
TN
Enumeration date
01/13/2006
Last updated
03/07/2023
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