Provider Demographics
NPI:1952882680
Name:WORKMAN, CHARLES WADE II (DPH)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:WADE
Last Name:WORKMAN
Suffix:II
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ROCKY BOTTOM DR
Mailing Address - Street 2:
Mailing Address - City:UNICOI
Mailing Address - State:TN
Mailing Address - Zip Code:37692-4030
Mailing Address - Country:US
Mailing Address - Phone:423-743-9998
Mailing Address - Fax:423-743-7420
Practice Address - Street 1:110 ROCKY BOTTOM DR
Practice Address - Street 2:
Practice Address - City:UNICOI
Practice Address - State:TN
Practice Address - Zip Code:37692-4030
Practice Address - Country:US
Practice Address - Phone:423-743-9998
Practice Address - Fax:423-743-7420
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist