Organization
JENNIFER BROYLES MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BROYLES MD (PRESIDENT)
(423) 837-6000
Entity
Organization
Contact information
Practice address
1511 MAIN ST, KIMBALL, TN 37347-5551
(423) 837-6000
(423) 837-6009
Mailing address
PO BOX 8487, CHATTANOOGA, TN 37414-0487
(423) 899-2204
(423) 698-4045
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3370123
MEDICARE PTAN
TN
Enumeration date
03/18/2007
Last updated
10/24/2007
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