Individual
DR. CHARLES D HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5000 ALPHA LN, HIXSON, TN 37343-4054
(423) 870-1662
(423) 877-4845
Mailing address
PO BOX 22696, CHATTANOOGA, TN 37422-2696
(423) 870-1662
(423) 877-4845
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD0000011415
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080163948
MEDICARE RR
TN
05
—
3168293
—
TN
Enumeration date
03/13/2007
Last updated
12/18/2012
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