Individual
CHARLES WADE PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1303 RAGUET ST, NACOGDOCHES, TX 75961-4249
(936) 568-9600
(936) 568-9621
Mailing address
1303 RAGUET ST, NACOGDOCHES, TX 75961-4249
(936) 568-9600
(936) 568-9621
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K7468
TX
Other
Enumeration date
05/24/2006
Last updated
03/18/2016
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