Healthcare Provider Details

I. General information

NPI: 1861428898
Provider Name (Legal Business Name): BRIAN MCCARVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 WHITE AVE
HENDERSON TN
38340-1914
US

IV. Provider business mailing address

426 WHITE AVE
HENDERSON TN
38340-1914
US

V. Phone/Fax

Practice location:
  • Phone: 731-989-2174
  • Fax: 731-989-3891
Mailing address:
  • Phone: 731-989-2174
  • Fax: 731-989-3891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number37020
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: