Bryan J Prudhomme
MD | Pediatrics | Male
Bryan J Prudhomme, MD is a Johnson City, Tennessee based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Bryan J Prudhomme is
301 Med Tech Pkwy, Ste. 180, Johnson City, Tennessee - 37604. He can be contacted on phone at
423-794-5540 and fax number 423-926-3187.
Bryan J Prudhomme is a sole proprietor of his business.
NPI number (Unique professional ID) for Bryan J Prudhomme is
1528270816 which was assigned by NPPES on 07 May, 2007 and it was last updated on 11 Jul, 2018.
Bryan J Prudhomme license number is
42204 for Pediatrics (208000000X) in Tennessee.
Bryan J Prudhomme is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Bryan J Prudhomme basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Bryan J Prudhomme |
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| Credential : | MD |
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| Gender : | Male |
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Business Address:
Bryan J Prudhomme address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 301 Med Tech Pkwy, Ste. 180
Johnson City, TN, 37604
United States |
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| Phone Number : | 423-794-5540 |
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| Fax Number : | 423-926-3187 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1528270816 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 07 May, 2007 |
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| Last Updated On : | 11 Jul, 2018 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Bryan J Prudhomme are as mentioned. Primary taxonomy code for Bryan J Prudhomme, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 42204 | TN |
Legacy Identifiers:
Other legacy medical identifiers of Bryan J Prudhomme such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 3000368 | MEDICAID | TN | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 3889
Johnson City, TN, 37602-3889
United States |
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| Phone Number : | 423-794-5540 |
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| Fax Number : | 423-926-3187 |
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Business Location:
Patients can refer following map for directions to
Bryan J Prudhomme practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.