Individual
DR. JIM CARROLL BRASFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
320 BRISTOL BLVD W, BRISTOL, TN 37620-8765
(423) 844-6407
(423) 793-7004
Mailing address
PO BOX 17016, BRISTOL, VA 24209-7016
(423) 844-6407
(423) 793-7004
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
9991
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006101208
—
VA
01
—
140007601
RAIL ROAD MEDICARE
TN
01
—
3014517
UMWA
TN
01
—
361712500
DEPT OF LABOR
TN
01
—
4005735
BLUECROSS & BLUE SHIELD
TN
01
—
7817131
AETNA
TN
01
—
TN0101
JOHN DEERE
TN
Enumeration date
06/30/2006
Last updated
01/12/2017
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