Broffitt, Samuel Lee
Broffitt, Samuel Lee is an sole proprietor health care provider with primary practice located at 1995 Highway 51 S Suite 202, North Doctors Building, Covington TN 38019-3635. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Broffitt, Samuel Lee can be contacted via phone (901) 476-4526.Contact Information
Primary practice address
1995 Highway 51 S Suite 202, North Doctors Building
Covington TN 38019-3635
Phone: (901) 476-4526
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD13148 | Tennessee |
Profile Details
NPI number | 1790882595 |
---|---|
LBN Legal business name | Broffitt, Samuel Lee |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 20th, 2006 |
Last updated | Jul 8th, 2007 - about 17 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 | 1790882595 | NPPES |
Other | 032147 | AMERICAN BRD. OF FAM. P. | |
MEDICAID | 3185867 | AMERICAN BRD. OF FAM. P. | |
Other | 0016732 | AMERICAN BRD. OF FAM. P. |
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