Provider Demographics
NPI:1194037374
Name:CHARLES LINGUITI, MD, PC
Entity Type:Organization
Organization Name:CHARLES LINGUITI, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:LINGUITI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-566-8375
Mailing Address - Street 1:PO BOX 1165
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:AL
Mailing Address - Zip Code:36081-1165
Mailing Address - Country:US
Mailing Address - Phone:334-566-8375
Mailing Address - Fax:
Practice Address - Street 1:664 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:BRUNDIDGE
Practice Address - State:AL
Practice Address - Zip Code:36010-1202
Practice Address - Country:US
Practice Address - Phone:334-536-1001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-05
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.26698207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty