Healthcare Provider Details

I. General information

NPI: 1346347341
Provider Name (Legal Business Name): CHARLES M CARTON JR. DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6230 W CAPITOL DRIVE
MILWAUKEE WI
53216-2122
US

IV. Provider business mailing address

6230 W CAPITOL DRIVE
MILWAUKEE WI
53216-2122
US

V. Phone/Fax

Practice location:
  • Phone: 414-463-6301
  • Fax: 414-463-5263
Mailing address:
  • Phone: 414-463-6301
  • Fax: 414-463-5263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number368025
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: