Individual
DR. CHARLES RILEY LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1088 LONDON LINKS DR, FOREST, VA 24551-4662
(434) 534-6868
(434) 534-8808
Mailing address
1088 LONDON LINKS DR, FOREST, VA 24551-4662
(434) 534-6868
(434) 534-8808
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102205093
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207Q00000X
FAMILY MEDICINE
VA
Enumeration date
06/06/2015
Last updated
01/18/2022
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