IndividualActive
Charles Harris, PA
NPI 1386780237 · Medical Physician Assistant · Jackson, WY
Provider details
- NPI number
- 1386780237
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- 76 (WY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
982 W. Broadway
Jackson, WY 83002
Phone: (307) 733-8002
Fax: (307) 733-0032
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 15240
Jackson, WY 83002-5240
Registry dates
- Enumerated
- 2007-01-29
- Last updated
- 2007-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.