Provider Demographics
NPI:1134347891
Name:GLEATON, CHARLES PEYTON (MSPAS, PA-C)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:PEYTON
Last Name:GLEATON
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Gender:M
Credentials:MSPAS, PA-C
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Mailing Address - Street 1:1300 MICCOSUKEE RD
Mailing Address - Street 2:BIXLER EMERGENCY CENTER
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5054
Mailing Address - Country:US
Mailing Address - Phone:850-431-0911
Mailing Address - Fax:850-431-0779
Practice Address - Street 1:1300 MICCOSUKEE RD
Practice Address - Street 2:BIXLER EMERGENCY CENTER
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5054
Practice Address - Country:US
Practice Address - Phone:850-431-0911
Practice Address - Fax:850-431-0779
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2016-03-31
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9104132363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical