Provider Demographics
NPI:1083870539
Name:TERRY, BRITTNEY R (DO)
Entity Type:Individual
Prefix:DR
First Name:BRITTNEY
Middle Name:R
Last Name:TERRY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E SPRINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1761
Mailing Address - Country:US
Mailing Address - Phone:423-530-7970
Mailing Address - Fax:423-530-7971
Practice Address - Street 1:2002 BROOKSIDE DR STE 200
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4634
Practice Address - Country:US
Practice Address - Phone:423-530-7970
Practice Address - Fax:423-530-7971
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2239208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1083870539Medicaid
TN1523707Medicaid
TN103I377092Medicare PIN
TN1523707Medicaid