Provider Demographics
NPI:1891777835
Name:PLIMPTON, CHARLES STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:STEVEN
Last Name:PLIMPTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 748860
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8860
Mailing Address - Country:US
Mailing Address - Phone:602-241-1717
Mailing Address - Fax:602-265-7216
Practice Address - Street 1:515 E THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-3203
Practice Address - Country:US
Practice Address - Phone:602-241-1717
Practice Address - Fax:602-265-7216
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ20429207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ105818Medicaid
AZF23036Medicare UPIN
AZMD20429Medicare ID - Type Unspecified