Individual
EMILY CHARLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
155 HOSPITAL DR STE 205, LAFAYETTE, LA 70503-2852
(337) 484-1091
(337) 484-1092
Mailing address
155 HOSPITAL DR STE 205, LAFAYETTE, LA 70503-2852
(374) 841-0913
(337) 484-1092
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
307726
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2016
Last updated
06/11/2019
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