Provider Demographics
NPI:1336182096
Name:CHARLES S. BETTS, MD
Entity Type:Organization
Organization Name:CHARLES S. BETTS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:COCKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-629-7710
Mailing Address - Street 1:350 NORTH COX STREET
Mailing Address - Street 2:SUITE #16
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-5514
Mailing Address - Country:US
Mailing Address - Phone:336-629-7710
Mailing Address - Fax:336-629-6123
Practice Address - Street 1:350 NORTH COX STREET
Practice Address - Street 2:SUITE #16
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5514
Practice Address - Country:US
Practice Address - Phone:336-629-7710
Practice Address - Fax:336-629-6123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18490207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC15409OtherBCBS
NC8915409Medicaid
NC8915409Medicaid
NCC80699Medicare UPIN