| Ethan George Brouillette, | |
|
3110 Windemere Cir, Nashville, TN 37214-1616 | |
| (262) 483-9269 | |
| Not Available |
| Full Name | Ethan George Brouillette |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 4 Years |
| Location | 3110 Windemere Cir, Nashville, Tennessee |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245956580 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Beaman Physician Services, Pc | 6406218130 | 55 |
| Entity Name | Beaman Physician Services, PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487342242 PECOS PAC ID: 6406218130 Enrollment ID: O20230814000206 |
| Entity Name | Warner Physician Services PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770272221 PECOS PAC ID: 0345602801 Enrollment ID: O20230815002672 |
| Mailing Address | Practice Location Address |
|---|---|
| Ethan George Brouillette, 3110 Windemere Cir, Nashville, TN 37214-1616 Ph: (262) 483-9269 | Ethan George Brouillette, 3110 Windemere Cir, Nashville, TN 37214-1616 Ph: (262) 483-9269 |
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