Healthcare Provider Details

I. General information

NPI: 1720201122
Provider Name (Legal Business Name): ROBERT MICHAEL BROWNYARD DPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

557 E MAIN ST
PARSONS TN
38363-2752
US

IV. Provider business mailing address

557 E MAIN ST PO BOX 307
PARSONS TN
38363-2752
US

V. Phone/Fax

Practice location:
  • Phone: 731-847-4013
  • Fax: 731-847-4016
Mailing address:
  • Phone: 731-847-4013
  • Fax: 731-847-4016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number3943
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: