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General NPI Number Information
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NPI Number | 1871724708
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Entity Type | Organization
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Legal Business Name | BISE, PLLC
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Dates
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Enumeration Date | 07/27/2009
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 114 BELLAMY AVENUE
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City | SURGOINSVILLE
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State | TN
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Zip | 37873
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Country | US
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Telephone | 423-345-0333
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Fax | 423-345-0336
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Provider Business Mailing Address
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Address Line | P.O. BOX 105
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City | SURGOINSVILLE
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State | TN
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Zip | 37873
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Country | US
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Telephone | 423-345-0333
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Fax | 423-345-0336
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MRS. BETH A BRYAN
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Credential | PHARMD
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Telephone | 423-345-0333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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