Kergosien, Charles A

Kergosien, Charles A is an sole proprietor health care provider with primary practice located at 527 Silver Cross Dr , Brookhaven MS 39601-2388. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kergosien, Charles A can be contacted via phone (601) 835-0507.

Contact Information

Primary practice address
527 Silver Cross Dr Brookhaven MS 39601-2388
Phone: (601) 835-0507
Fax: (601) 835-2766
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 15445 Mississippi

Profile Details

NPI number 1619087541
LBN Legal business name Kergosien, Charles A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2006
Last updated Jan 18th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619087541 NPPES
Mississippi MEDICAID 00118411

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