Provider Demographics
NPI:1376779215
Name:PLAYER, CHARLES SCOT (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:SCOT
Last Name:PLAYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4448 W LOOMIS RD
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-4800
Mailing Address - Country:US
Mailing Address - Phone:414-281-5150
Mailing Address - Fax:414-281-5767
Practice Address - Street 1:4448 W LOOMIS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-4800
Practice Address - Country:US
Practice Address - Phone:414-281-5150
Practice Address - Fax:414-281-5767
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI61133-21207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine