Provider Demographics
NPI:1336346535
Name:GUY, CHARLES WALKER II (DO)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:WALKER
Last Name:GUY
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 W CENTRAL TEXAS EXPY STE 210
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76548-7469
Mailing Address - Country:US
Mailing Address - Phone:254-618-4933
Mailing Address - Fax:254-202-7999
Practice Address - Street 1:101 BURNETT CT STE B
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-3100
Practice Address - Country:US
Practice Address - Phone:254-504-6163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0727207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty