Individual
CHARLTON A PETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1254 NASHVILLE HWY, LEWISBURG, TN 37091-2222
(931) 359-7677
(931) 359-7784
Mailing address
1254 NASHVILLE HWY, LEWISBURG, TN 37091-2222
(931) 359-7677
(931) 359-7784
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
DPM303
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0490250001
NSC PALMETTO GBA REG C
—
05
—
3351297
—
TN
01
—
66264
BLUE CROSS BLUE SHIELD
TN
Enumeration date
10/20/2006
Last updated
02/12/2008
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