Provider Demographics
NPI:1881897817
Name:CHARTON, JUSTIN WAYNE (MD)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:WAYNE
Last Name:CHARTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-5424
Mailing Address - Country:US
Mailing Address - Phone:501-327-4444
Mailing Address - Fax:
Practice Address - Street 1:924 MAIN ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-5424
Practice Address - Country:US
Practice Address - Phone:501-327-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5917207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology