Individual
BRYANT KIRK FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-5249
Mailing address
5141 RED ROBIN LN, KINGSPORT, TN 37664-4733
(423) 288-6585
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1554
TN
Other
Enumeration date
01/07/2008
Last updated
01/07/2008
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