Provider Demographics
NPI:1770766487
Name:DR. CHARLES CARTON JR., SC
Entity type:Organization
Organization Name:DR. CHARLES CARTON JR., SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:414-463-6301
Mailing Address - Street 1:6230 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2122
Mailing Address - Country:US
Mailing Address - Phone:414-463-6301
Mailing Address - Fax:414-463-5263
Practice Address - Street 1:6230 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2122
Practice Address - Country:US
Practice Address - Phone:414-463-6301
Practice Address - Fax:414-463-5263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI368-025332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4673420001Medicare NSC