Provider Demographics
NPI:1790893543
Name:SHERRILL, JOHN BRANSON (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BRANSON
Last Name:SHERRILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LANTANA ROAD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-1903
Mailing Address - Country:US
Mailing Address - Phone:931-484-5141
Mailing Address - Fax:931-484-5620
Practice Address - Street 1:100 LANTANA ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-1903
Practice Address - Country:US
Practice Address - Phone:931-484-5141
Practice Address - Fax:931-484-5620
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD19898207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN99839OtherBLUE CROSS
110028747OtherRAILROAD MEDICARE
TN3045497Medicaid
TN3045497Medicaid
TN3045498Medicare ID - Type Unspecified