Broffitt, Samuel Lee

Broffitt, Samuel Lee is an sole proprietor health care provider with primary practice located at 1995 Highway 51 S Suite 202, North Doctors Building, Covington TN 38019-3635. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Broffitt, Samuel Lee can be contacted via phone (901) 476-4526.

Contact Information

Primary practice address
1995 Highway 51 S Suite 202, North Doctors Building Covington TN 38019-3635
Phone: (901) 476-4526
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD13148 Tennessee

Profile Details

NPI number 1790882595
LBN Legal business name Broffitt, Samuel Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790882595 NPPES
Other 032147 AMERICAN BRD. OF FAM. P.
MEDICAID 3185867 AMERICAN BRD. OF FAM. P.
Other 0016732 AMERICAN BRD. OF FAM. P.

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