Individual
DR. CHARLES S ERCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 RIVER NORTH BLVD, STEPHENVILLE, TX 76401-1803
(254) 968-6051
(254) 968-4204
Mailing address
150 RIVER NORTH BLVD, STEPHENVILLE, TX 76401-1803
(254) 968-6051
(254) 968-4204
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
H9912
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112329100
FIRST CARE PROVIDER NUMBE
TX
01
—
129363501
UNITED HEALTHCARE PROV NO
TX
05
—
136752602
—
TX
01
—
4620657
AETNA PROVIDER NUMBER
TX
01
—
7675525001
CIGNA PROVIDER NUMBER
TX
01
—
83J075
BCBS PROVIDER NUMBER
TX
01
—
930033133
RAILROAD MEDICARE
TX
Enumeration date
06/20/2005
Last updated
09/27/2012
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