Healthcare Provider Details

I. General information

NPI: 1801811799
Provider Name (Legal Business Name): CHARLES ALAN OGLES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83745 HWY 9
ASHLAND AL
36251
US

IV. Provider business mailing address

83745 HWY 9
ASHLAND AL
36251
US

V. Phone/Fax

Practice location:
  • Phone: 256-354-5064
  • Fax: 256-354-7099
Mailing address:
  • Phone: 256-354-5064
  • Fax: 256-354-7099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number000022026
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: