Individual
MR. CHARLES W. KUEBLER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
164 W HEWETT RD, SANTA ROSA BEACH, FL 32459-3310
(850) 278-3821
(850) 475-4781
Mailing address
PO BOX 2699, ATTN: SHMG/HPE, PENSACOLA, FL 32513-2699
(850) 278-3821
(850) 475-4781
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA9100651
FL
363A00000X
Physician Assistant
Primary
PA9100651
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290755100
—
FL
Enumeration date
08/31/2006
Last updated
06/16/2016
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