Individual
CHARLES GARRETH CLINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1542 TULANE AVE, NEW ORLEANS, LA 70112-2865
(504) 568-4624
Mailing address
1533 HIGHWAY 163, JONESBORO, AR 72404-8612
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
323158
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2017
Last updated
07/06/2020
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