Provider Demographics
NPI:1457564643
Name:INGLE, CHARLES HEBER
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:HEBER
Last Name:INGLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 W VERNON AVE
Mailing Address - Street 2:#C
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85007-1200
Mailing Address - Country:US
Mailing Address - Phone:714-865-4500
Mailing Address - Fax:
Practice Address - Street 1:1501 W VERNON AVE
Practice Address - Street 2:#C
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85007-1200
Practice Address - Country:US
Practice Address - Phone:714-865-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other