Holly Broadwater
Pain Medicine
101 Med Tech Pkwy Suite 200
Johnson City
, Tennessee 37604-4007
Holly Broadwater
Pain Medicine
101 Med Tech Pkwy Suite 200
Johnson City
, Tennessee 37604-4007
(423) 232-6120
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About
Features
Specialties
- Pain Medicine
Languages spoken
- English
Location
First Address
- Holly Broadwater
- 101 Med Tech Pkwy Suite 200
- Johnson City, TN
- Zip : 37604-4007
- Phone : (423) 232-6120
Second Address
- Holly Broadwater
- 101 Med Tech Pkwy Suite 200
- Johnson City, TN
- Zip : 37604-4007
- Phone : (423) 232-6120
Reviews
FAQs
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What type of doctor is Holly Broadwater
In what state does Holly Broadwater practice in?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2081P2900X | Pain Medicine | 0370804-22 | TN |
National Provider Identifier
| NPI | 1134164205 |
|---|---|
| Provider Name | Holly Broadwater |
| First Address | Johnson City, TN 37604-4007 |
| Second Address | Johnson City, TN 37604-4007 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/06/2006 |
| Last Update Date | 02/03/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 4078380 | BLUE CROSS/BLUE SHIELD (01) | TN |
| P00102426 | MEDICARE RAILROAD (01) | TN |
| P74568 | (02) | TN |
| TN0122 | JOHN DEERE (JC) (01) | TN |
| TN0123 | JOHN DEERE (KPT) (01) | TN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.