Charles B Idom is a Urology in Dalton, Georgia. Charles B Idom practices all healthcare services and medical treatments related to Urology. The NPI Number for Charles B Idom is 1316943210. The last update date is 2017-09-11.
Charles B Idom's current location address is 1434 Broadrick Dr, Dalton, Georgia. You can contact this provider via phone number 7062785961 and fax number 7062750280. The mailing address for Charles B Idom is 1434 Broadrick Dr, Dalton, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Charles B Idom |
|---|---|
| Address | 1434 Broadrick Dr, Dalton, Georgia |
| Phone Number | 7062785961 |
| Fax Number | 7062750280 |
| Sole Proprietor | Y |
| Credentials | M.D., FACS |
NPI Number Detail
| NPI Number | 1316943210 |
|---|---|
| Provider Enumeration Date | 2005-06-24 |
| Last Updated Date | 2017-09-11 |
Provider Mailing Address Detail
| Address | 1434 Broadrick Dr |
|---|---|
| City | Dalton |
| State | Georgia (GA) |
| Post Code | 307203009 |
| Phone Number | 7062785961 |
| Fax Number | 7062750280 |
Provider's Primary Taxonomy Detail
| Speciality | Urology |
|---|---|
| Taxonomy | 208800000X |
| Licence No | 50482 |
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Definition: A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquir |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 340019475 | GA | RAILROAD MEDICARE | |
| 00931312A | GA | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Charles B Idom by the Centers for Medicare & Medicaid Services?
The Charles B Idom has been issued the NPI (National Provider Identifier) 1316943210. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Charles B Idom is geographically located?
The Charles B Idom is physically situated at the following location: 1434 Broadrick Dr, Dalton, GA, 307203009.
What is Charles B Idom's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Charles B Idom is Urology, and the taxonomy code that categorizes this field of expertise is 208800000X.
On what date was the 1316943210 assigned to Charles B Idom?
The Charles B Idom was issued its 1316943210 on 2005-06-24, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Charles B Idom, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Charles B Idom, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2017-09-11.