Doctor Name: | CHARLES LILLY |
NPI Number: | 1467433193 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 7261 |
Business Practice Address: | 5 Mobile Infirmary Cir Mobile, AL - 366073513 |
Business Phone Number: | 2514600326 |
Business Fax Number: | 2514602846 |
Mailing Address: | Po Box 9369, MOBILE |
State: | AL |
Postal Code: | 366910369 |
Phone Number: | 2514600326 |
Fax Number: | 2514602846 |
NPI Enumeration Date: | 11/09/2005 |
NPI Last Update Date: | 09/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 7261 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |