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1902851496
CHARLES L PUCKETT
COLUMBIA, MO
NPI
1902851496
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2086S0122X Surgery Plastic and Reconstructive Surgery
(Licence: MO MDR6610)
Enumeration Date
2006-05-23
Last Update Date
2012-04-25
Business Address
CHARLES L PUCKETT MD
ONE HOSPITAL DRIVE
COLUMBIA, MO 65212-0001
Phone number: 573-882-2275
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Mailing Address
CHARLES L PUCKETT MD
PO BOX 7687
COLUMBIA, MO 65205-7687
Phone number: 573-882-2259
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