Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 4301092662 | MI |
Y | 207PE0004X | Emergency Medical Services | 35.125338 | OH |
NPI | 1063674075 |
---|---|
Provider Name | Dr. Thomas Edgar Charlton |
First Address | Batavia, OH 45103-1921 |
Second Address | Batavia, OH 45103-1921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 11/03/2017 |