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General NPI Number Information
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NPI Number | 1013995513
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Entity Type | Individual
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Provider Name | RONALD KERRY BRAWLEY PA
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Gender | Male
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Dates
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Enumeration Date | 01/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1771 MADISON ST SUITE 210
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City | CLARKSVILLE
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State | TN
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Zip | 37043-3160
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Country | US
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Telephone | 931-551-1507
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Fax | 931-551-1505
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Provider Business Mailing Address
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Address Line | 3801 HEAD RD
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City | ADAMS
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State | TN
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Zip | 37010-9132
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Country | US
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Telephone | 931-551-1507
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Fax | 931-551-1505
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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