Individual
DR. CHARLES EDGAR INGALLS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., FACS
Contact information
Practice address
2055 E. SOUTH BLVD, SUITE 908, MONTGOMERY, AL 36116-2014
(334) 284-6500
(334) 284-6202
Mailing address
2055 E. SOUTH BLVD, SUITE 908, MONTGOMERY, AL 36116-2014
(334) 284-6500
(334) 284-6202
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6026
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000089020
—
AL
01
—
51089020
BCBS
AL
Enumeration date
07/25/2006
Last updated
03/12/2012
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