Provider Demographics
NPI:1124227640
Name:CHARLES E. FOSTER, D. C. P. C.
Entity Type:Organization
Organization Name:CHARLES E. FOSTER, D. C. P. C.
Other - Org Name:CHARLES E FOSTER D C P C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:478-474-3883
Mailing Address - Street 1:3323 NORTHSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-2503
Mailing Address - Country:US
Mailing Address - Phone:478-474-3883
Mailing Address - Fax:478-474-3884
Practice Address - Street 1:3323 NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2503
Practice Address - Country:US
Practice Address - Phone:478-474-3883
Practice Address - Fax:478-474-3884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2884305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU17710Medicare UPIN
GA35ZCBBNMedicare PIN