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Dr. Brandon Justin Fazalare, MD
Student in an Organized Health Care Education/Training Program in Johnson City, Tennessee
NPI 1609565860

Brandon Justin Fazalare is a Student in an Organized Health Care Education/Training Program based in Johnson City, TN. Brandon Justin Fazalare practices in Johnson City, TN and has the professional credentials of MD. The NPI Number for Brandon Justin Fazalare is 1609565860 and holds a License No. (Tennessee).

The current practice location address for Brandon Justin Fazalare is 325 N State Of Franklin Rd Fl 3, Johnson City, TN and can be reached out via phone at 423-439-7201 and via fax at 423-439-7219.

Location: 325 N State Of Franklin Rd Fl 3, Johnson City, TN, 37604-6171
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1609565860
Provider Name
Brandon Justin Fazalare
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
325 N State Of Franklin Rd Fl 3, Johnson City, TN, 37604-6171
Phone Number
423-439-7201
Fax Number
423-439-7219
Provider Enumeration Date
05/03/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
325 N State Of Franklin Rd Fl 3
City
Johnson City
State
Tennessee
Zip
37604-6171
Phone Number
423-439-7201
Fax Number
423-439-7219
person
Provider Business Mailing Address Details
Address
325 N State Of Franklin Rd Fl 3
City
Johnson City
State
Tennessee
Zip
37604-6171
Phone Number
423-439-7201
Fax Number
423-439-7219
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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