# CHARLES R. ADCOCK, MDPC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649460213
- **Authorized official:** MRS. TERRY LEA BURROWS (OFFICE MANAGER)
- **Authorized official phone:** (423) 837-7144

## Contact information

- **Practice address:** 520 E 12TH ST, SOUTH PITTSBURG, TN 37380-1633
- **Practice address phone:** (423) 837-7144
- **Practice address fax:** (423) 837-8428
- **Mailing address:** 520 E 12TH ST, SOUTH PITTSBURG, TN 37380-1633
- **Mailing address phone:** (423) 837-7144
- **Mailing address fax:** (423) 837-8428

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | MD011688 | TN | Yes |

## Other

- **Enumeration date:** 07/30/2007
- **Last updated:** 01/28/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3723335 | — | TN |
| 01 | — | C10664 | MEDICARE RAILROAD | TN |