Puckett, Charles L

Puckett, Charles L is an individual health care provider with primary practice located at One Hospital Drive , Columbia MO 65212-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Puckett, Charles L can be contacted via phone (573) 882-2275.

Contact Information

Primary practice address
One Hospital Drive Columbia MO 65212-0001
Phone: (573) 882-2275
Fax: (573) 884-4788
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X MDR6610 Missouri

Profile Details

NPI number 1902851496
LBN Legal business name Puckett, Charles L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Apr 25th, 2012 - about 13 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 1902851496 NPPES
Missouri Other 240004071 RR MEDICARE
Missouri MEDICAID 200469708 RR MEDICARE

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