Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 32972 | AL |
N | 2086S0120X | Pediatric Surgery | 36023 | SC |
N | 2086S0120X | Pediatric Surgery | P8248 | TX |
NPI | 1497829337 |
---|---|
Provider Name | Charles William Hartin JR. |
First Address | Mobile, AL 36640-0480 |
Second Address | Mobile, AL 36604-3304 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 20/06/2016 |