MEDICARE: DR. CHARLES WAYNE BINGHAM DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	6177	TN

General Provider Information

NPI Number	:	1023546413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES WAYNE BINGHAM DO

Provider Business Mailing Address
First Line	:	1123 E LAMAR ALEXANDER PKWY
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37804-5130
Country	:	US
Telephone Number	:	865-233-0568
Fax Number	:

Provider Business Practice Location Address
First Line	:	1123 E LAMAR ALEXANDER PKWY
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37804-5130
Country	:	US
Telephone Number	:	570-867-1617
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2017
Last Update Date	:	01/05/2026

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