Individual
CHARLES W. KLEIN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
218 QUARTERMAN ST, WAYCROSS, GA 31501-3547
(912) 287-0301
(912) 287-0301
Mailing address
218 QUARTERMAN ST, WAYCROSS, GA 31501-3547
(912) 287-0301
(912) 287-1568
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005819
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003103924D
—
GA
Enumeration date
05/25/2010
Last updated
02/24/2014
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