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1235464918

NPI Code Detail

MEDICARE: MR. CHARLES M. ALDRICH PA-C

MEDICARE: MR. CHARLES M. ALDRICH PA-C

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	207P00000X	Emergency Medicine Physician	1784	TN
2	207Q00000X	Family Medicine Physician	1784	TN
3	207R00000X	Internal Medicine Physician	1784	TN
4	208000000X	Pediatrics Physician	1784	TN
5	208100000X	Physical Medicine & Rehabilitation Physician	1784	TN
6	2085R0202X	Diagnostic Radiology Physician	1784	TN
7	208600000X	Surgery Physician	1784	TN
8	363AM0700X	Medical Physician Assistant	PA 1784	TN

General Provider Information

NPI Number	:	1235464918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES M. ALDRICH PA-C

Provider Business Mailing Address
First Line	:	620 SKYLINE DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38301-3923
Country	:	US
Telephone Number	:	731-541-6574
Fax Number	:	731-541-6042

Provider Business Practice Location Address
First Line	:	620 SKYLINE DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38301-3923
Country	:	US
Telephone Number	:	731-541-6574
Fax Number	:	731-541-6042

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

Provider Enumeration Date	:	10/13/2009
Last Update Date	:	05/11/2026

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Directions to “ MR. CHARLES M. ALDRICH PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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