Individual
CHARLES L HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1932 ALCOA HWY, SUITE 255, KNOXVILLE, TN 37920-1527
(865) 544-1869
(865) 544-6533
Mailing address
1932 ALCOA HWY, SUITE 255, KNOXVILLE, TN 37920-1527
(865) 544-1869
(865) 544-6533
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1522
TN
363A00000X
Physician Assistant
Primary
PA02309
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3665105
MEDICARE
TN
05
—
3665105
—
TN
01
—
4164939
BCBS
TN
01
—
4164942
BCBS
TN
01
—
87N249
BCBS
TX
Enumeration date
07/18/2006
Last updated
03/31/2008
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