Eisenhauer, Charles Nicholas

Eisenhauer, Charles Nicholas is an individual health care provider with primary practice located at 6029 Walnut Grove Rd Ste 404 , Memphis TN 38120-2112. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Eisenhauer, Charles Nicholas can be contacted via phone (901) 726-1056.

Contact Information

Primary practice address
6029 Walnut Grove Rd Ste 404 Memphis TN 38120-2112
Phone: (901) 726-1056
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X P Kentucky
Allopathic & Osteopathic Physicians / Surgery 208600000X 71735 Minnesota
Allopathic & Osteopathic Physicians / Surgery 208600000X 57079 Tennessee

Profile Details

NPI number 1275775587
LBN Legal business name Eisenhauer, Charles Nicholas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2009
Last updated Jul 5th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275775587 NPPES
Tennessee Other 57079 TN STATE LICENSE
Tennessee Other 48491 TN STATE LICENSE
Tennessee MEDICAID 0148667 TN STATE LICENSE
Tennessee MEDICAID 7100133120 TN STATE LICENSE

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