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Dr. Charles B Idom JR., MD,FACS
Urology Physician in Dalton, Georgia
NPI 1316943210

Charles B Idom JR. is a Urology Physician based in Dalton, GA. Charles B Idom JR. practices in Dalton, GA and has the professional credentials of MD,FACS. The NPI Number for Charles B Idom JR. is 1316943210 and holds a License No. 050482 (Georgia).

The current practice location address for Charles B Idom JR. is 1434 Broadrick Dr, Dalton, GA and can be reached out via phone at 706-278-5961 and via fax at 706-275-0280.

Location: 1434 Broadrick Dr, Dalton, GA, 30720-3009
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1316943210
Provider Name
Charles B Idom JR.
Credential
MD,FACS
Provider Entity Type
Individual
Gender
Male
Address
1434 Broadrick Dr, Dalton, GA, 30720-3009
Phone Number
706-278-5961
Fax Number
706-275-0280
Provider Enumeration Date
06/24/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
340019475 01 GA RAILROAD MEDICARE
00931312A 05 GA
institution
Provider Business Practice Location Address Details
Address
1434 Broadrick Dr
City
Dalton
State
Georgia
Zip
30720-3009
Phone Number
706-278-5961
Fax Number
706-275-0280
person
Provider Business Mailing Address Details
Address
1434 Broadrick Dr
City
Dalton
State
Georgia
Zip
30720-3009
Phone Number
706-278-5961
Fax Number
706-275-0280
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Urology
Speciality
-
Taxonomy
208800000X
License No.
050482 (Georgia)
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
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