| Doctor Name: | CHARLIE HUMPHRIES |
| NPI Number: | 1336355098 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 15675 |
| Business Practice Address: | 802 North Jefferson St Albany, GA - 31701 |
| Business Phone Number: | 2298838602 |
| Business Fax Number: | 2298838604 |
| Mailing Address: | 802 North Jefferson St, ALBANY |
| State: | GA |
| Postal Code: | 31701 |
| Phone Number: | 2298838602 |
| Fax Number: | 2298838604 |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 15675 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |