Healthcare Provider Details

I. General information

NPI: 1710925847
Provider Name (Legal Business Name): CHARLES J. KOCHERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 MIDDLE CREEK RD
SEVIERVILLE TN
37862
US

IV. Provider business mailing address

133 GALLAHAD CT
SEVIERVILLE TN
37876-3801
US

V. Phone/Fax

Practice location:
  • Phone: 865-453-7111
  • Fax:
Mailing address:
  • Phone: 865-908-6094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberTN32012
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTP571
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number32012
License Number StateTN
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number32012
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: