Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | DI 28188 | FL |
NPI | 1962552026 |
---|---|
Provider Name | Ronald K Charlton |
First Address | Jacksonville, FL 32216-6321 |
Second Address | Jacksonville, FL 32209-6533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 08/07/2007 |