Provider Demographics
NPI:1235475500
Name:DEUBERT, CHARLES BARRETT (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:BARRETT
Last Name:DEUBERT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18575 MARTEL RD
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-4237
Mailing Address - Country:US
Mailing Address - Phone:865-456-6217
Mailing Address - Fax:
Practice Address - Street 1:18575 MARTEL RD
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-4237
Practice Address - Country:US
Practice Address - Phone:865-456-6217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC2487111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor