Provider Demographics
NPI:1295954956
Name:FLYNN, CHARLES F (PA)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:F
Last Name:FLYNN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2296 US 70 HWY
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-8209
Mailing Address - Country:US
Mailing Address - Phone:828-686-5232
Mailing Address - Fax:828-686-7269
Practice Address - Street 1:2296 US 70 HWY
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778-8209
Practice Address - Country:US
Practice Address - Phone:828-686-5232
Practice Address - Fax:828-686-7269
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102730363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01649OtherBCBS GROUP NUMBER
NC01649OtherBCBS GROUP NUMBER
NCMF0456245OtherDEA NUMBER