Provider Demographics
NPI:1013995513
Name:BRAWLEY, RONALD KERRY (PA)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:KERRY
Last Name:BRAWLEY
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:3801 HEAD RD
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:TN
Mailing Address - Zip Code:37010-9132
Mailing Address - Country:US
Mailing Address - Phone:931-551-1507
Mailing Address - Fax:931-551-1505
Practice Address - Street 1:1771 MADISON ST
Practice Address - Street 2:SUITE 210
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-3160
Practice Address - Country:US
Practice Address - Phone:931-551-1507
Practice Address - Fax:931-551-1505
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q23325Medicare UPIN