Healthcare Provider Details

I. General information

NPI: 1659592236
Provider Name (Legal Business Name): WILLIAM BRYAN GLOVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 09/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 DICKERSON PIKE
NASHVILLE TN
37207-2539
US

IV. Provider business mailing address

2020 21ST AVE S SUITE 201
NASHVILLE TN
37212-4354
US

V. Phone/Fax

Practice location:
  • Phone: 615-769-4401
  • Fax: 615-769-4730
Mailing address:
  • Phone: 615-269-0652
  • Fax: 615-269-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2007-00600
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number47088
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: