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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013911890 NPPES
Tennessee MEDICAID 3814287
Tennessee MEDICAID 005644721
Tennessee MEDICAID 005627605

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