Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | K1806 | TX |
Y | 208600000X | Surgeon | K1806 | TX |
NPI | 1003899980 |
---|---|
Provider Name | Charles R Day |
First Address | Killeen, TX 76540-0938 |
Second Address | Killeen, TX 76549-4143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2005 |
Last Update Date | 15/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
155221801 | (05) | TX |
H70331 | (02) | TX |