Individual
DR. CHARLES W CLOGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10100 KANIS RD, LITTLE ROCK, AR 72205-6202
(501) 255-6000
(501) 255-6400
Mailing address
10100 KANIS RD, LITTLE ROCK, AR 72205-6202
(501) 255-6000
(501) 255-6400
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
E0428
AR
207UN0901X
Nuclear Cardiology Physician
E0428
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127369001
—
AR
Enumeration date
06/01/2006
Last updated
03/24/2014
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