CHARLES WALLER, MD

General Practice

Active Individual
NPI: 1306841341

Practice Address

218 BASS LN
Benton, KY 42025

Phone: (270) 556-3239

Specialties

Specialty Code Primary License
General Practice 208D00000X Yes 29738 (KY)
Emergency Medicine 207P00000X No 29738 (KY)

Frequently Asked Questions

NPI 1306841341 is the National Provider Identifier for CHARLES WALLER, MD, a General Practice provider located in Benton, KY. This NPI was enumerated on June 16, 2005.
CHARLES WALLER, MD practices at 218 BASS LN, Benton, KY 42025.

Quick Facts

NPI
1306841341
Type
Individual
Enumerated
Jun 16, 2005
Last Updated
Feb 1, 2017

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