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Organization

DYERSBURG CLINIC CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBBIE T BREWER (DIRECTOR)
(615) 465-7626
Entity
Organization

Contact information

Practice address
400 E TICKLE ST, DYERSBURG, TN 38024-3120
(731) 288-7250
(731) 288-7258
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
(615) 465-7000
(615) 309-3338

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
TN
207RG0100X
Gastroenterology Physician
207X00000X
Orthopaedic Surgery Physician
208600000X
Surgery Physician
2086S0129X
Vascular Surgery Physician
208800000X
Urology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3718531
TN
01
4085237
BCBS
TN
Enumeration date
06/20/2005
Last updated
08/25/2010
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