Provider Demographics
NPI:1346347341
Name:CARTON, CHARLES M JR (DPM)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:M
Last Name:CARTON
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 W CAPITOL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2122
Mailing Address - Country:US
Mailing Address - Phone:414-463-6301
Mailing Address - Fax:414-463-5263
Practice Address - Street 1:6230 W CAPITOL DRIVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2122
Practice Address - Country:US
Practice Address - Phone:414-463-6301
Practice Address - Fax:414-463-5263
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI368025213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43215300Medicaid
WI43215300Medicaid
T61642Medicare UPIN