Dr CHARLES A MANGHAM JR. MD is a male medical professional, specializing in Otolaryngology. He graduated in 1970 from University Of Virginia School Of Medicine.
ST LUKES CLINIC - WOOD RIVER LLC
100 HOSPITAL DR
KETCHUM
ID
83340
Tel:
| Npi | 1972565224 |
| Pac Id | 9739110305 |
| Professional Enrollment Id | I20140714002385 |
| Last Name | MANGHAM |
| First Name | CHARLES |
| Middle Name | A |
| Suffix | JR. |
| Gender | M |
| Credential | MD |
| Medical School Name | UNIVERSITY OF VIRGINIA SCHOOL OF MEDICINE |
| Graduation Year | 1970 |
| Primary Specialty | OTOLARYNGOLOGY |
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| Organization Legal Name | ST LUKES CLINIC - WOOD RIVER LLC |
| Group Practice Pac Id | 3173783818 |
| Number Of Group Practice Members | 49 |
| Line 1 Street Address | 100 HOSPITAL DR |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | Y |
| City | KETCHUM |
| State | ID |
| Zip Code | 83340 |
| Phone Number | |
| Hospital Affiliation Ccn 1 | 131323 |
| Hospital Affiliation Lbn 1 | ST LUKE'S WOOD RIVER MEDICAL CENTER |
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| Professional Accepts Medicare Assignment | Y |
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