DR. BRYAN DOHERTY (NPI# 1811200033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811200033 |
| Entity Type | Individual |
| Full Name | DR. BRYAN DOHERTY |
| Credential | MD |
| Practice Address |
113 Highway 70 E Dickson TN 37055-2075 |
| Mailing Address |
127 Crestview Park Dr Suite 209 Dickson TN 37055-2855 |
| Practice Telephone | 6154414448 |
| Practice Fax Number | 6154414446 |
| Mailing Telephone | 6154465121 |
| Mailing Fax Number | 6154461357 |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2020-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD54388 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q022944 | 05 | |
| TN | MEDICAL LICENSE | MD54388 | 01 |
| TN | BCBS TN | 5581316 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497123384 | Bryan Doherty | Internal Medicine | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2015-09-09 |
| 1972645943 | Bryan Doherty | Optometrist | 5100 Clayton Rd, Ste D30, Concord, CA 94521-3104 | 2007-02-13 |
| Street Address |
113 HIGHWAY 70 E |
| City | DICKSON |
| State | TN |
| Zip Code | 37055-2075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718272 | David J Blazer | Internal Medicine | 113 Highway 70 E, Dickson, TN 37055-2080 | 2005-05-23 |
| 1568464873 | Dickson Medical Associates PC | Family Medicine | 113 Highway 70 E, Dickson, TN 37055-2080 | 2005-06-01 |
| 1770586745 | Robert Thuan | Surgery | 113 Highway 70 E, Dickson, TN 37055-2075 | 2005-05-24 |
| 1306849377 | Eldred H Wiser | Surgery | 113 Highway 70 E, Dickson, TN 37055-2075 | 2005-05-24 |
| 1558364794 | Daniel B Drinnen | Family Medicine | 113 Highway 70 E, Dickson, TN 37055-2080 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801406186 | Raven Julia Jackson | Dentist | 445 Tn-46 S, Dickson, TN 37055 | 2020-08-03 |
| 1336767839 | Logan Newman | Student in an Organized Health Care Education/Training Program | 102 Us70 East, Suite 2, Dickson, TN 37055 | 2020-07-10 |
| 1720575012 | Vb Tennessee I Pllc | Dentist | 2027 Thornton Dr, Dickson, TX 37055 | 2018-04-23 |
| 1376075358 | Sharon Elizabeth Sharber | Nurse Practitioner | 111 Highway 70 E Ste E, Dickson, TN 37055 | 2017-03-29 |
| 1992255921 | Karen Alonzo | Occupational Therapy Assistant | 312 N Charlotte St, Dickson, TN 37055 | 2016-10-13 |
| 1356727408 | Aurora Pharmacy Inc | Pharmacy | 318 East College Street, Suite 102, Dickson, TN 37055 | 2015-07-30 |
| 1295121820 | Jeffrey Nicholas Williams | Pharmacy Technician | 120 Brazzell Rd, Dickson, TN 37055 | 2015-04-10 |
| 1760894398 | Joshua A. Vaughn | Physical Therapist | 766 Highway 46 South, Dickson, TN 37055 | 2014-06-02 |
| 1902217292 | Keith Payton | Dentist | 217 Highway 46 Ste D, Dickson, TN 37055 | 2014-05-08 |
| 1073953840 | John Harrison | Dentist | 134 Us-70, Dickson Pediatric Dentistry, Dickson, TN 37055 | 2013-06-26 |
| Find all providers in zip 37055 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295929255 | Emad Mustafa Dodin | Internal Medicine | 113 Highway 70 E Ste G, Dickson, TN 37055-2075 | 2007-09-04 |
| 1093718272 | David J Blazer | Internal Medicine | 113 Highway 70 E, Dickson, TN 37055-2080 | 2005-05-23 |
| 1467645903 | Ehab S Kasasbeh | Internal Medicine | 113 Highway 70 East, Dickson, TN 37055-2075 | 2007-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053935437 | Cvc Pllc | Internal Medicine | 22 Deepwood Dr, Jackson, TN 38305-9679 | 2020-06-02 |
| 1073085189 | Heart Center Usa Incorporated | Internal Medicine | 6500 Kirby Gate Blvd, Memphis, TN 38119-2673 | 2018-12-31 |
| 1700357035 | Morristown Heart, Pllc | Internal Medicine | Morristown Heart, Pllc, 735 Mcfarland Street, Morristown, TN 37814 | 2018-12-16 |
| 1902353444 | Hh Physician Care-elkton Tennessee | Internal Medicine | 1446 Bryson Road, Ardmore, TN 38449 | 2016-09-01 |
| 1902352750 | Rose Marie Robertson | Internal Medicine | 4003 Newman Pl, Nashville, TN 37204-4308 | 2016-08-31 |
| 1013374073 | Amg Crockett LLC | Internal Medicine | 1611 S Locust Ave, Suite 200b, Lawrenceburg, TN 38464-4055 | 2016-01-21 |
| 1821488727 | Bruce Wilson Md PC | Internal Medicine | 5885 Airline Rd, # 985, Arlington, TN 38002-5127 | 2015-01-29 |
| 1982013215 | Blue Ridge Medical Management Corporation | Internal Medicine | 1901 S Shady St Ste 1, Mountain City, TN 37683-2021 | 2014-08-12 |
| 1871835892 | Robert Maxwell Smith | Internal Medicine | 1004 Deep Woods Trl, Brentwood, TN 37027-6309 | 2013-03-18 |
| 1750630794 | David Marc Mirvis | Internal Medicine | 5676 Redding Ave, Memphis, TN 38120-1848 | 2012-09-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.