Individual
STACY DAVID BREWINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
228 W. 4TH STREET, SUITE 200, COOKEVILLE, TN 38501
(931) 372-0405
(931) 372-0463
Mailing address
228 WEST 4TH STREET, SUITE 200, COOKEVILLE, TN 38501
(931) 372-0405
(931) 372-0463
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
30775
TN
207RI0011X
Interventional Cardiology Physician
Primary
MD30775
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3836719
—
TN
01
—
4288870
BCBS
TN
05
—
7100015180
—
KY
Enumeration date
08/22/2006
Last updated
06/16/2022
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