Healthcare Provider Details

I. General information

NPI: 1083675896
Provider Name (Legal Business Name): CHARLES DAVID HORD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 RANDOLPH RD
CHARLOTTE NC
28211-1075
US

IV. Provider business mailing address

PO BOX 5615
FRESNO CA
93755-5615
US

V. Phone/Fax

Practice location:
  • Phone: 704-377-1647
  • Fax: 704-358-8267
Mailing address:
  • Phone: 559-436-1000
  • Fax: 559-354-4235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number9500943
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number9500943
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: