Provider Demographics
NPI:1104922657
Name:CHLEBISCH, ERIC R (PA)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:R
Last Name:CHLEBISCH
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:1406 TUSCULUM BLVD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4332
Mailing Address - Country:US
Mailing Address - Phone:423-787-7080
Mailing Address - Fax:423-787-7087
Practice Address - Street 1:1406 TUSCULUM BLVD
Practice Address - Street 2:SUITE 2000
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4332
Practice Address - Country:US
Practice Address - Phone:423-787-7080
Practice Address - Fax:423-787-7087
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNPA0000001364363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical