Individual
DR. BRIAN DAVID SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
105 W STONE DR, STE 3A, KINGSPORT, TN 37660-3365
(423) 392-6200
(423) 392-6593
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 857-2070
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
2009-01336
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
DO2151
TN
Other
Enumeration date
08/28/2007
Last updated
02/03/2012
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