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General NPI Number Information
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NPI Number | 1841499902
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Entity Type | Individual
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Provider Name | DAVID R. CHARLES D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 100 N EAGLE CREEK DR
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City | LEXINGTON
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State | KY
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Zip | 40509-1805
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Country | US
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Telephone | 859-258-5300
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Fax | 859-258-5357
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Provider Business Mailing Address
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Address Line | 1221 S BROADWAY
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City | LEXINGTON
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State | KY
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Zip | 40504-2701
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Country | US
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Telephone | 859-258-6200
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Fax | 859-258-6203
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 05277
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 036128090
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 05277
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036128090
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License Number State | IL
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