Individual
DR. MARK BRUMMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
102 E RAVINE RD, KINGSPORT, TN 37660-3814
(423) 245-9600
(423) 245-9634
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO1970
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507939
—
TN
01
—
3714470
GROUP MEDICARE PIN
TN
Enumeration date
12/29/2006
Last updated
01/16/2024
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