Etherton, Charlie

Etherton, Charlie is an individual health care provider with primary practice located at 1124 Fox Meadows Blvd Suite 2, Sevierville TN 37862-6927. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Etherton, Charlie can be contacted via phone (865) 453-5530.

Contact Information

Primary practice address
1124 Fox Meadows Blvd Suite 2 Sevierville TN 37862-6927
Phone: (865) 453-5530
Fax: (865) 453-2671
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA0842 Tennessee

Profile Details

NPI number 1700990025
LBN Legal business name Etherton, Charlie
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated Apr 23rd, 2020 - about 5 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 1700990025 NPPES
Tennessee Other P00339849 RR MEDICARE PIN

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