Provider Demographics
NPI:1962741587
Name:ERPENBACH, DAVID CHARLES (PA-C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CHARLES
Last Name:ERPENBACH
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 ACCELERATOR WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-3078
Mailing Address - Country:US
Mailing Address - Phone:655-462-6638
Mailing Address - Fax:865-546-9047
Practice Address - Street 1:1600 ACCELERATOR WAY STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-3078
Practice Address - Country:US
Practice Address - Phone:655-462-6638
Practice Address - Fax:865-546-9047
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2285363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
9490971OtherAETNA
TN1531205Medicaid
TNQ000683Medicaid
TN4346659OtherBLUECROSS BLUESHIELD
TNP01235676OtherRAILROAD MEDICARE
TN4346660OtherBLUECROSS BLUESHIELD - PA AT SURGERY
TN103I977924Medicare PIN
TN4346660OtherBLUECROSS BLUESHIELD - PA AT SURGERY
TNQ000683Medicaid