Individual
CHARLES C INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1265 UNION AVE, MEMPHIS, TN 38104-3415
(901) 725-5846
Mailing address
6060 PRIMACY PKWY, SUITE 241, MEMPHIS, TN 38119-5745
(901) 725-5846
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
30064
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120711
—
MS
05
—
140245001
—
AR
05
—
205095300
—
MO
01
—
3091897
BLUECROSS BLUESHIELD
TN
05
—
3825084
—
TN
01
—
50065532
MEDICARE RAILROAD
—
01
—
97920
BLUECROSS BLUESHIELD
AR
Enumeration date
05/22/2006
Last updated
01/24/2025
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