Organization
RENAISSANCE HEALTH AND SURGICAL ASSOCIATES, P.C.
Active
Other names
RENAISSANCE HEALTH AND SURGICAL ASSOCIATES, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE LYNN BREWER (PRACTICE MANAGER)
(423) 837-5801
Entity
Organization
Contact information
Practice address
325 S CEDAR AVE, SUITE 2, SOUTH PITTSBURG, TN 37380-1305
(423) 837-5801
(423) 837-5807
Mailing address
325 S CEDAR AVE, SUITE 2, SOUTH PITTSBURG, TN 37380-1305
(423) 837-5801
(423) 837-5807
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
30628
TN
207VG0400X
Gynecology Physician
30628
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3149771
BCBS TN
TN
01
—
891-08307
BCBS AL PROV #
AL
Enumeration date
01/24/2007
Last updated
08/16/2021
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