Individual
CHARLES DAVIS FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
631 RB WILSON DR, HUNTINGDON, TN 38344-1727
(731) 986-4461
(865) 291-3228
Mailing address
PO BOX 636019, CINCINNATI, OH 45263-6019
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
38666
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3898586
—
TN
01
—
4110535
BCBS
TN
01
—
P00255517
RAILROAD MEDICARE
TN
Enumeration date
06/06/2006
Last updated
11/07/2007
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