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Individual

DR. DANIEL W. BRUCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
708 EVERETT ST, TIPTONVILLE, TN 38079
(731) 882-1135
(731) 859-4404
Mailing address
507 CHERRY ST, TIPTONVILLE, TN 38079-1527
(731) 882-1135
(731) 859-4404

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
MD23021
TN
207Q00000X
Family Medicine Physician
Primary
MD23021
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
182011
UNISON HEALTH PLAN
TN
01
21913
MEMPHIS MANAGED CARE
TN
05
4447958
TN
Enumeration date
06/09/2006
Last updated
08/31/2011
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