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Individual

BYRON J BLOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
112 AIRPORT BUSINESS PARK DR, SHELBYVILLE, TN 37160-7452
(931) 680-6360
(931) 680-9909
Mailing address
2503 BURGESS ST, MURFREESBORO, TN 37128-7641
(615) 519-3775

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
922
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1801074042
NPI
TN
01
922
PA LICENSE NUMBER
TN
Enumeration date
02/08/2008
Last updated
04/02/2026
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