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Charles Waller, MD
Emergency Medicine Physician in Benton, Kentucky
NPI 1306841341

Charles Waller is a Emergency Medicine Physician based in Benton, KY. Charles Waller practices in Benton, KY and has the professional credentials of MD. The NPI Number for Charles Waller is 1306841341 and holds a License No. 29738 (Kentucky).

The current practice location address for Charles Waller is 218 Bass Ln, Benton, KY and can be reached out via phone at 270-556-3239 and via fax at 270-354-5865.

Location: 218 Bass Ln, Benton, KY, 42025-5824
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306841341
Provider Name
Charles Waller
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
218 Bass Ln, Benton, KY, 42025-5824
Phone Number
270-556-3239
Fax Number
270-354-5865
Provider Enumeration Date
06/16/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4047217 05 TN
64297385 05 KY
institution
Provider Business Practice Location Address Details
Address
218 Bass Ln
City
Benton
State
Kentucky
Zip
42025-5824
Phone Number
270-556-3239
Fax Number
270-354-5865
person
Provider Business Mailing Address Details
Address
218 Bass Ln
City
Benton
State
Kentucky
Zip
42025-5824
Phone Number
270-556-3239
Fax Number
270-354-5865
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Emergency Medicine
Speciality
-
Taxonomy
207P00000X
License No.
29738 (Kentucky)
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
29738 (Kentucky)
Definition
Definition to come...
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