| Doctor Name: | CHARLES HENLEY MEDBERY |
| NPI Number: | 1528063609 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 107212 |
| Business Practice Address: | 401 Woodland Hills Blvd Fort Scott, KS - 667018797 |
| Business Phone Number: | 6202232200 |
| Business Fax Number: | |
| Mailing Address: | 5800 Foxridge Dr, Ste 240 MISSION |
| State: | KS |
| Postal Code: | 662022338 |
| Phone Number: | 9132613153 |
| Fax Number: | 9132623295 |
| NPI Enumeration Date: | 06/16/2005 |
| NPI Last Update Date: | 08/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 107212 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |