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Individual

DR. DEANA R BROTHERTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
653 MERCHANTS GREENE BLVD., SUITE 201, MORRISTOWN, TN 37813
(423) 492-6700
(865) 374-2131
Mailing address
653 MERCHANTS GREENE BLVD., SUITE 201, MORRISTOWN, TN 37813
(423) 492-6700
(865) 374-2131

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD30887
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100028814
PHP
TN
01
3142811
BCBST
TN
01
3144180
BCBST
TN
01
3144181
BCBST
TN
01
3144182
BLUECARE-BOGARD
TN
05
3846342
TN
Enumeration date
01/26/2006
Last updated
04/27/2023
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