Organization
CHARLES H. TADLOCK, M.D. LTD
Active
Organization
CHARLES H. TADLOCK, M.D. LTD
Active
Parent organization
CHARLES H. TADLOCK, M.D. LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHARLES H. TADLOCK, M.D. LTD
Authorized official
CHARLES H TADLOCK M.D. (OWNER)
(702) 474-0200
Entity
Organization
Contact information
Practice address
6725 S EASTERN AVE STE 6, LAS VEGAS, NV 89119-3949
(702) 474-0200
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2019927
—
NV
Enumeration date
05/13/2010
Last updated
03/01/2011
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