Individual
CHARLIE WEICHIN FANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13851 HIGHWAY 28, WHITWELL, TN 37397-5373
(423) 653-9210
Mailing address
12708 EARLY RD, KNOXVILLE, TN 37922-6130
(865) 310-2773
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101251958
VA
207P00000X
Emergency Medicine Physician
055513
GA
207P00000X
Emergency Medicine Physician
38728
TN
207Q00000X
Family Medicine Physician
Primary
38728
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
331010801A
—
GA
05
—
3898281
—
TN
01
—
4087933
BCBSTN
TN
05
—
64088644
—
KY
01
—
P00231542
RAILROAD
TN
01
—
P00288351
RAILROAD
GA
Enumeration date
10/05/2006
Last updated
12/07/2023
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