Individual
CHARLES BURKHEAD HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 TYSON AVE, PARIS, TN 38242-4579
(731) 642-0025
(731) 644-0899
Mailing address
305 TYSON AVE, PARIS, TN 38242-4579
(731) 642-0025
(731) 644-0899
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD0000007370
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070014703
RAILROAD MEDICARE
TN
05
—
1520224
—
TN
Enumeration date
11/15/2005
Last updated
01/21/2013
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