Healthcare Provider Details

I. General information

NPI: 1679567390
Provider Name (Legal Business Name): BRIGHTON FAMILY MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 06/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 OLD HWY 51 SUITE C
BRIGHTON TN
38011
US

IV. Provider business mailing address

1880 OLD HWY 51 SUITE C
BRIGHTON TN
38011-0117
US

V. Phone/Fax

Practice location:
  • Phone: 907-837-7979
  • Fax: 901-837-7999
Mailing address:
  • Phone: 907-837-7979
  • Fax: 901-837-7999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SCOTT CRAIG
Title or Position: PART OWNER/PHYSICAIN
Credential: MD
Phone: 901-837-7979