Individual provider · Type 1 NPI

Charley Crockett

Physician Assistant · Jacksboro, TN

NPI number 1376419960 Active

Practice location

2702 Jacksboro Pike
Jacksboro, TN 37757-4850

Call (423) 374-7775 Map

Fax (423) 374-7779

Mailing address

4196 Highway 62 412 Ste A
Hardy, AR 72542-8002

Other practice locations

  • 120 Tanner Pl, Clinton, TN 37716-6684 · (865) 855-3500

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X6819 (TN)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

15 other providers at this address

Other physician assistant providers in Jacksboro

See all in Jacksboro →

About NPI 1376419960

Charley Crockett's National Provider Identifier is 1376419960, issued on Oct 13, 2025. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Jacksboro, TN. The record was last updated on Jan 14, 2026.