Individual
DR. CHARLES BRUCE MACDONALD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1910 NONCONNAH BLVD, SUITE 120, MEMPHIS, TN 38132-2113
(901) 448-2300
(901) 448-6657
Mailing address
66 N PAULINE ST, SUITE 206, MEMPHIS, TN 38105-5105
(901) 448-7642
(901) 448-8015
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
31879
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3844858
—
TN
Enumeration date
04/24/2006
Last updated
07/08/2007
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