Individual
ALEX JAMES CHARBONEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 S JACKSON ST, LOUISVILLE, KY 40202-1622
(502) 852-5193
Mailing address
550 S JACKSON ST, LOUISVILLE, KY 40202-1622
(502) 852-5193
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
60508
KY
208600000X
Surgery Physician
60951432
WA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/28/2019
Last updated
06/02/2025
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