Individual
MR. CHARLES M. ALDRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-6574
(731) 541-6042
Mailing address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-6574
(731) 541-6042
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1784
TN
207Q00000X
Family Medicine Physician
1784
TN
207R00000X
Internal Medicine Physician
1784
TN
208000000X
Pediatrics Physician
1784
TN
208100000X
Physical Medicine & Rehabilitation Physician
1784
TN
2085R0202X
Diagnostic Radiology Physician
1784
TN
208600000X
Surgery Physician
1784
TN
363AM0700X
Medical Physician Assistant
Primary
PA 1784
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12221983
BIRTH DATE
TN
Enumeration date
10/13/2009
Last updated
05/11/2026
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