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Individual

DR. CHARLES RANDLE DISHONGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1467 HIGHWAY 1 SOUTH, GREENVILLE, MS 38701
(662) 335-1621
(662) 335-8128
Mailing address
P. O. BOX 4618, GREENVILLE, MS 38701-4618
(662) 335-1621
(662) 335-8128

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
07645
MS

Other

Enumeration date
09/29/2006
Last updated
07/08/2007
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