Herndon, Charles H

Herndon, Charles H is an individual health care provider with primary practice located at 1104 Professional Blvd , Dalton GA 30720-2588. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Herndon, Charles H can be contacted via phone (706) 226-5533.

Contact Information

Primary practice address
1104 Professional Blvd Dalton GA 30720-2588
Phone: (706) 226-5533
Fax: (706) 428-0033
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 013818 Georgia
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 013818 Georgia

Profile Details

NPI number 1316030398
LBN Legal business name Herndon, Charles H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 2nd, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316030398 NPPES
Georgia Other 023789 BCBS EDI
Georgia MEDICAID 00136991A BCBS EDI

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