Mabry, Charles D
Mabry, Charles D is an sole proprietor health care provider with primary practice located at 1609 W 40Th Ave Ste 403 , Pine Bluff AR 71603-6365. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mabry, Charles D can be contacted via phone (870) 535-8280.Contact Information
Primary practice address
1609 W 40Th Ave Ste 403
Pine Bluff AR 71603-6365
Phone: (870) 535-8280
Fax: (870) 535-5458
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | C4953 | Arkansas |
Profile Details
| NPI number | 1225026875 |
|---|---|
| LBN Legal business name | Mabry, Charles D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 7th, 2005 |
| Last updated | Oct 11th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225026875 | NPPES |
| Arkansas | MEDICAID | 104825001 |
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