Individual
HARRY PHILLIP CLAYBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-1121
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD33815
TN
207R00000X
Internal Medicine Physician
Primary
MD33815
TN
208000000X
Pediatrics Physician
MD33815
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005844223
—
VA
01
—
103I119100
MEDICARE PTAN BRMC
TN
01
—
110216162
RAILROAD MEDICARE
SD
01
—
3145651
BCBS TN PROVIDE #
TN
01
—
382283
ANTHEM
VA
Enumeration date
06/24/2005
Last updated
02/27/2024
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