Provider Demographics
NPI:1376579235
Name:WARD, CHARLEY FRANZ (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLEY
Middle Name:FRANZ
Last Name:WARD
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 1:851 WEST ELK AVENUE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643-2946
Mailing Address - Country:US
Mailing Address - Phone:423-542-2913
Mailing Address - Fax:423-542-3485
Practice Address - Street 1:851 W ELK AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-2946
Practice Address - Country:US
Practice Address - Phone:423-542-2913
Practice Address - Fax:423-542-3485
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2006744OtherBLUE CROSS BLUE SHIELD
TN2006744OtherBLUE CROSS BLUE SHIELD
TNT74472Medicare UPIN