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NPI Code Detail

MEDICARE: DR. CHARLES T DELLINGER MD

MEDICARE: DR. CHARLES T DELLINGER 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
12080A0000XPediatric Adolescent Medicine PhysicianME24210FL
2208000000XPediatrics PhysicianME24210FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114990157
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES T DELLINGER MD
Provider Business Mailing Address
First Line : PO BOX 746638
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6638
Country : US
Telephone Number : 904-202-1032
Fax Number : 904-376-4107
Provider Business Practice Location Address
First Line : 2140 SMITH ST
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-5554
Country : US
Telephone Number : 904-269-2140
Fax Number : 904-264-3018
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2006
Last Update Date : 01/24/2023

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Directions to “ DR. CHARLES T DELLINGER MD” Practice Location

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