Individual
DR. BLAKE RANDOLPH CHARLTON
Active
Individual
DR. BLAKE RANDOLPH CHARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
162201
AK
207RI0011X
Interventional Cardiology Physician
Primary
162044
AK
207RI0011X
Interventional Cardiology Physician
Primary
162201
AK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2013
Last updated
01/14/2026
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