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Individual

CHARLES L BACKUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
273 HIGHWAY 11 E, BULLS GAP, TN 37711-3433
(423) 393-4146
(423) 393-4377
Mailing address
273 HIGHWAY 11 E STE E, BULLS GAP, TN 37711-3434
(423) 393-4146
(423) 393-4377

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO1551
TN
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
1551
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3300057
TN
Enumeration date
03/27/2006
Last updated
02/12/2026
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