Individual
CHARLES A. VERMONT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1480 W 1ST ST N, PRESCOTT, AR 71857-3339
(870) 887-2669
(870) 887-5373
Mailing address
PO BOX 550, PRESCOTT, AR 71857-0550
(870) 887-2669
(870) 887-5373
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C7159
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080103771
RAILROAD MEDICARE
—
05
—
112773001
—
AR
01
—
127710000
QUAL CHOICE
AR
Enumeration date
07/01/2005
Last updated
06/06/2008
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