Organization
CHARLES W PAGE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES W PAGE MD (OWNER)
(936) 568-9600
Entity
Organization
Contact information
Practice address
1320 N UNIVERSITY DR STE A, NACOGDOCHES, TX 75961-4270
(936) 568-9600
(936) 568-9621
Mailing address
1320 N UNIVERSITY DR STE A, NACOGDOCHES, TX 75961-4270
(936) 568-9600
(936) 568-9621
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K7468
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005NL
BLUE CROSS NUMBER
TX
Enumeration date
05/26/2006
Last updated
06/07/2021
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