Basic Information
| Provider Information | |||||||||
| NPI: | 1396961785 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASBURY | ||||||||
| FirstName: | BRANDON | ||||||||
| MiddleName: | SHANE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 827 E LAMAR ALEXANDER PKWY | ||||||||
| Address2: | |||||||||
| City: | MARYVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378045001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8659840900 | ||||||||
| FaxNumber: | 8659841035 | ||||||||
| Practice Location | |||||||||
| Address1: | 827 E LAMAR ALEXANDER PKWY | ||||||||
| Address2: | |||||||||
| City: | MARYVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378045001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8659840900 | ||||||||
| FaxNumber: | 8659841035 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 06/14/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 46078 | TN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | P00895867 | 01 | RAILROAD MEDICARE | OTHER | 9465481 | 01 | TN | AETNA | OTHER | 1521060 | 05 | TN | MEDICAID | 4269785 | 01 | TN | BLUECROSS BLUESHIELD | OTHER |