Individual
DR. CHARLES F SHERROD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1531 W 32ND ST STE 102, JOPLIN, MO 64804-1651
(417) 781-3630
(417) 781-9814
Mailing address
1531 W 32ND ST STE 102, JOPLIN, MO 64804-1651
(417) 781-3630
(417) 781-9814
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
04-28135
KS
207W00000X
Ophthalmology Physician
MD.019476
LA
207W00000X
Ophthalmology Physician
Primary
R4P23
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100125980A
—
KS
05
—
100125980B
—
KS
01
—
100833
BC/BS
KS
05
—
203032107
—
MO
01
—
23833
BC/BS
MO
Enumeration date
06/23/2006
Last updated
09/17/2019
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