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General NPI Number Information
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NPI Number | 1568991552
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Entity Type | Individual
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Provider Name | CHARLES ROTENBERRY MD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 1900 PINE ST
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City | ABILENE
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State | TX
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Zip | 79601-2432
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Country | US
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Telephone | 325-670-2277
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Fax | 325-672-8292
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Provider Business Mailing Address
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Address Line | PO BOX 1198
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City | ABILENE
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State | TX
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Zip | 79604-1198
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Country | US
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Telephone | 325-670-4372
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Fax | 325-670-4040
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | T6030
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License Number State | TX
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