Provider Demographics
NPI:1023047768
Name:ARNETTE, BRYAN T (MD)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:T
Last Name:ARNETTE
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:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37662-0009
Mailing Address - Country:US
Mailing Address - Phone:423-857-2093
Mailing Address - Fax:423-857-2012
Practice Address - Street 1:1754 US HIGHWAY 23 N
Practice Address - Street 2:
Practice Address - City:WEBER CITY
Practice Address - State:VA
Practice Address - Zip Code:24290-7071
Practice Address - Country:US
Practice Address - Phone:276-386-5980
Practice Address - Fax:276-386-9387
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238390207Q00000X
TNMD42511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1023047768Medicaid
VAP00406040Medicare PIN
VA1023047768Medicaid
TN3700592Medicare PIN
VACA0736Medicare PIN
VA013392H81Medicare PIN
TN0281780001Medicare PIN
VAC06181Medicare PIN
TN0281780003Medicare PIN
TN3000694Medicare PIN
TN103I086169Medicare UPIN
VAP0040640Medicare PIN