Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 01052194A | IN |
NPI | 1013941830 |
---|---|
Provider Name | Charles Philip Bartley JR. |
First Address | Indianapolis, IN 46237-6340 |
Second Address | Indianapolis, IN 46237-6340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 24/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200264850 | (05) | IN |
A14929 | (02) | IN |