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Individual

DR. SAMUEL LEE BROFFITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1995 HIGHWAY 51 S, SUITE 202, NORTH DOCTORS BUILDING, COVINGTON, TN 38019-3635
(901) 476-4526
Mailing address
PO BOX 784, COVINGTON, TN 38019-0784
(901) 476-4526

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD13148
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0016732
BLUE CROSS
TN
01
032147
AMERICAN BRD. OF FAM. P.
05
3185867
TN
Enumeration date
09/20/2006
Last updated
07/08/2007
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