Individual
BRIAN P DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353
Mailing address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19590
TN
208M00000X
Hospitalist Physician
19590
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010344638
—
VA
01
—
201217521
PHP
TN
05
—
3046236
—
TN
01
—
4121972
BCBST
TN
01
—
TN0111
JOHN DEERE HEALTHCARE
TN
Enumeration date
12/20/2005
Last updated
10/10/2013
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