Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHARLES WALLER, MD
ActiveCHARLES WALLER, MD is a General Practice healthcare provider located in BENTON, Kentucky. NPI 1306841341 is currently active in the NPPES registry. Verify at CMS.
General Practice · BENTON, KY
Registration Details
- NPI Number
- 1306841341
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 16, 2005 (21.195080748678 yrs)
- Last Updated
- Feb 1, 2017
- Licenses
-
29738 (KY)29738 (KY)
Practice Information
- Address
-
218 BASS LNBENTON, KY, 420255824Browse KY providers · Browse ZIP 42025
- Phone
- 2705563239
- Fax
- 2703545865
- Primary Specialty
-
General Practice
208D00000X
- Additional Specialty
- Emergency Medicine
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.