Basic Information
| Provider Information | |||||||||
| NPI: | 1396061560 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRAY | ||||||||
| FirstName: | SHEREE | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., FACS | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 70575 | ||||||||
| Address2: | DEPARTMENT OF SURGERY | ||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376141708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234396268 | ||||||||
| FaxNumber: | 4234396259 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 N STATE OF FRANKLIN RD | ||||||||
| Address2: | |||||||||
| City: | JOHNSON CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376046035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234316111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2010 | ||||||||
| LastUpdateDate: | 07/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 0101260274 | VA | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0127X | 0000055916 | TN | Y | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery |
No ID Information.