DR.CHARLES W. KEBLUSEK NPI 1639351562

NPI Information

  • NPI: 1639351562
  • Provider Name: DR.CHARLES W. KEBLUSEK
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 1409 HUGUENOT RD
    SUITE 101
    MIDLOTHIAN, VA
    ZIP 23113
  • Phone: (804) 379-0094

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NPI Details

DR.CHARLES W. KEBLUSEK is a specialist in Midlothian, VA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR.CHARLES W. KEBLUSEK NPI is 1639351562. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1409 HUGUENOT RD
SUITE 101
MIDLOTHIAN, VA
ZIP 23113-603
Phone: (804) 379-0094
Fax: (804) 379-9701

The provider's authorized official is Lynne Johnson .
The authorized official title is Office Manager and has the following contact phone number (804) 379-0094.

The enumeration date for this NPI number is 12/3/2007 and was last updated on 12/27/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist0101027033VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1B09610MEDICARE UPIN
2C03461MEDICARE PIN
3065061OTHERANTHEM PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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