Provider Demographics
NPI:1275594533
Name:THIGPEN, CHARLOTTE A (RPT)
Entity Type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:A
Last Name:THIGPEN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048A S BROAD ST
Mailing Address - Street 2:BROOKLEY COMPLEX
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36615-1285
Mailing Address - Country:US
Mailing Address - Phone:251-433-1414
Mailing Address - Fax:251-433-9634
Practice Address - Street 1:2048A S BROAD ST
Practice Address - Street 2:BROOKLEY COMPLEX
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36615-1285
Practice Address - Country:US
Practice Address - Phone:251-433-1414
Practice Address - Fax:251-433-9634
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1218225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-31733OtherBC/BS OF ALABAMA
ALQ63492Medicare UPIN