Provider Demographics
NPI:1245343003
Name:ATNIP, CHARLES D (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:D
Last Name:ATNIP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1050 N JAMES CAMPBELL BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-2754
Mailing Address - Country:US
Mailing Address - Phone:931-375-1050
Mailing Address - Fax:931-381-4101
Practice Address - Street 1:1050 N JAMES CAMPBELL BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2754
Practice Address - Country:US
Practice Address - Phone:931-375-1050
Practice Address - Fax:931-381-4101
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2011-10-03
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Provider Licenses
StateLicense IDTaxonomies
TNMD23689207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F31302Medicare UPIN
TN3068661Medicare ID - Type Unspecified