Provider Demographics
NPI:1881711653
Name:MARABLE, CHARLES TRENTON (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:TRENTON
Last Name:MARABLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MALLORY LN STE 202
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8235
Mailing Address - Country:US
Mailing Address - Phone:615-771-8181
Mailing Address - Fax:
Practice Address - Street 1:2001 MALLORY LN STE 202
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8235
Practice Address - Country:US
Practice Address - Phone:615-771-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31269207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF81148Medicare UPIN