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Individual

DR. CHARLES P HADDAD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
105 E MARKET ST, SOMERVILLE, TN 38068-1407
(901) 465-3955
(901) 465-6797
Mailing address
PO BOX 489, SOMERVILLE, TN 38068-0489
(901) 465-3955
(901) 465-6797

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T377
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13963
TLC MEMPHIS MANAGED CARE
01
2240072
UNITED HEALTHCARE
01
410026537
RAIL ROAD MEDICARE
01
47519
TN CARE
TN
01
47519
BLUE CROSS BLUE SHIELD
01
5843
OMNI
TN
Enumeration date
10/27/2005
Last updated
07/29/2008
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