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Individual

CHARLES P ISBELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5414 S BROADWAY AVE, TYLER, TX 75703-1335
(903) 581-1601
Mailing address
1406 COLLEGE DR 1, TEXARKANA, TX 75503-3580
(903) 614-7693
(903) 614-5343

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J0014
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
137957014
TX
05
137957015
TX
01
1N3830
MEDICARE RAILROAD
TX
01
1N3844
MEDICARE RAILROAD
TX
01
Q00053119
MCRR
TX
Enumeration date
05/24/2006
Last updated
05/12/2021
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