Melton, Charles L

Melton, Charles L is an individual health care provider with primary practice located at 2604 Saint Michael Dr Ste 345, Texarkana TX 75503-2379. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Melton, Charles L can be contacted via phone (903) 838-5500.

Contact Information

Primary practice address
2604 Saint Michael Dr Ste 345 Texarkana TX 75503-2379
Fax: (903) 838-7402
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X F6942 Texas

Profile Details

NPI number 1962444166
LBN Legal business name Melton, Charles L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Apr 28th, 2010 - about 15 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 1962444166 NPPES
Arkansas MEDICAID 128230001
Arkansas Other 3250610
Arkansas MEDICAID 100150730A
Arkansas Other 8G3790
Arkansas Other 19559000040
Arkansas Other 97146
Arkansas Other O60068553
Arkansas Other 0004314459
Arkansas MEDICAID 047791102

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