Individual
CHARLES PHILLIP BRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
101 E BLOUNT AVE STE 800, KNOXVILLE, TN 37920-1669
(865) 632-5900
(865) 637-2114
Mailing address
101 E BLOUNT AVE STE 800, KNOXVILLE, TN 37920-1669
(865) 632-5900
(865) 637-2114
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA98
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3046804
BCBSTN
TN
05
—
3665072
—
TN
Enumeration date
10/06/2006
Last updated
07/09/2007
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