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NPI Code Detail

MEDICARE: DR. CHARLES RAY PEARSON MD

MEDICARE: DR. CHARLES RAY PEARSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianMD.012218LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P00936767OTHERLARRMCARE THRU GPN MANY

General Provider Information

NPI Number : 1043258155
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES RAY PEARSON MD
Provider Business Mailing Address
First Line : 240 HIGHLAND DR
Second Line :
City : MANY
State : LA
Zip : 71449-3718
Country : US
Telephone Number : 318-256-5691
Fax Number : 318-256-6539
Provider Business Practice Location Address
First Line : 240 HIGHLAND DR
Second Line :
City : MANY
State : LA
Zip : 71449-3718
Country : US
Telephone Number : 318-256-5691
Fax Number : 318-256-6539
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 09/16/2011

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