Provider Demographics
NPI:1053307124
Name:CHARLOT, JOSEPH LEONCE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:LEONCE
Last Name:CHARLOT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 TAYLOR RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-2246
Mailing Address - Country:US
Mailing Address - Phone:757-465-4000
Mailing Address - Fax:
Practice Address - Street 1:2613 TAYLOR RD STE 23321
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-2246
Practice Address - Country:US
Practice Address - Phone:757-465-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0422472083P0500X, 2083P0901X
NJ25MA070416002083P0500X
VA01010578182083P0901X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG63171Medicare UPIN