Charles A Kergosien, M.D.
Internal Medicine in Brookhaven, MS. Individual provider (NPI-1).
NPI number1619087541
StatusActive
Last updated in NPPESJan 18, 2013
Details
- NPI
- 1619087541
- Entity type
- Individual (NPI-1)
- Name
- Charles A Kergosien
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 30, 2006
- Last updated
- Jan 18, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 15445 | MS | Yes |
Practice location
527 Silver Cross DrBrookhaven, MS 39601-2388
Phone 601-835-0507 · Fax 601-835-2766
Mailing address
Po Box 4177Brookhaven, MS 39603-6177
Phone 601-835-0507 · Fax 601-835-2766
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