Individual
BROCKTON JOLLY SANSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4220 HARDING PIKE, SUITE 500, NASHVILLE, TN 37205-2005
(615) 222-6977
Mailing address
501 GREAT CIRCLE RD, SUITE 200, NASHVILLE, TN 37228-1317
(615) 222-6977
(615) 222-5322
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
A97656
CO
208M00000X
Hospitalist Physician
Primary
49166
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530522
—
TN
01
—
4340915
BLUECROSS BLUESHIELD
TN
05
—
7100228510
—
KY
Enumeration date
08/24/2007
Last updated
06/15/2015
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