Individual
CHARLES CLOVER HUSTON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
116 CENTRAL AVE, OIL CITY, PA 16301-2736
(814) 676-0848
(814) 677-1289
Mailing address
121 DOCTORS LN, CLARION, PA 16214-8515
(814) 226-3470
(814) 226-3479
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD024985E
PA
2086S0129X
Vascular Surgery Physician
MD024985E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008098500003
—
PA
Enumeration date
02/23/2006
Last updated
05/17/2013
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