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General NPI Number Information
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NPI Number | 1932068038
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Entity Type | Individual
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Provider Name | GARY LYNN BRICKEY CSFA
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Gender | Male
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 400 N STATE OF FRANKLIN RD
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6035
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Country | US
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Telephone | 423-431-1410
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 BEECHWOOD DR
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6303
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Country | US
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Telephone | 423-863-3552
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Fax |
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 364
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License Number State | TN
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