Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Charles B Idom Jr., MD, FACS

Individual provider Urology Physician · NPI 1316943210

Dr. Charles B Idom Jr., MD, FACS is an Urology in Dalton, Georgia. Graduated from University of Mississippi School of Medicine in 1994, 32 years ago. Practices with North Georgia Urology Center, PC, Inc, a 6-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
32
Trained at
University of Mississippi School of Medicine
Licensed in
GA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
FACS — Fellow of the American College of Surgeons
A surgeon admitted as a fellow of the ACS.

See every abbreviation used in this directory →

Practice location Address checks out

1434 Broadrick Dr
Dalton, GA 30720-3009
Phone: (706) 278-5961
Fax: (706) 275-0280
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 050482 (GA)

Record details

NPI number1316943210
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , FACS
Sole proprietorYes
NPI enumeratedJune 24, 2005
Last updated in NPPESSeptember 11, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 1994 (32 years in practice)
Group practice North Georgia Urology Center, Pc, Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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