Individual
CHARLES MATTHEW PESSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
245 FLEMINGSBURG RD, MOREHEAD, KY 40351-1015
(606) 780-5500
(606) 783-7281
Mailing address
245 FLEMINGSBURG RD, MOREHEAD, KY 40351-1015
(606) 780-5500
(606) 783-7281
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
53502
KY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
53502
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53502
KY MEDICAL LICENSE
KY
05
—
7100658660
—
KY
Enumeration date
05/23/2005
Last updated
04/21/2020
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