Provider Demographics
NPI:1619403144
Name:DOERNER, CHARLES (DO)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:DOERNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 746652
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6652
Mailing Address - Country:US
Mailing Address - Phone:904-720-0599
Mailing Address - Fax:904-376-4036
Practice Address - Street 1:14534 OLD SAINT AUGUSTINE RD STE 3420
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-2645
Practice Address - Country:US
Practice Address - Phone:904-493-8001
Practice Address - Fax:904-376-3207
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2023-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS16718207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease