Brockmyre, Andrew
Brockmyre, Andrew is an individual health care provider with primary practice located at 240 Medical Park Blvd Ste 3600, Bristol TN 37620-7346. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Brockmyre, Andrew can be contacted via phone (423) 990-2400.Contact Information
Primary practice address
240 Medical Park Blvd Ste 3600
Bristol TN 37620-7346
Phone: (423) 990-2400
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD 29272 | Tennessee |
Profile Details
NPI number | 1013911890 |
---|---|
LBN Legal business name | Brockmyre, Andrew |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 9th, 2005 |
Last updated | Oct 9th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1013911890 | NPPES |
Tennessee | MEDICAID | 3814287 | |
Tennessee | MEDICAID | 005644721 | |
Tennessee | MEDICAID | 005627605 |
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