Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bryan J Prudhomme, MD

Individual provider Pediatrics Physician · NPI 1528270816

Bryan J Prudhomme, MD is a Pediatrics Physician in Johnson City, Tennessee. Licensed in Tennessee. Registered with an NPI since 2007.

Licensed in
TN
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

301 Med Tech Pkwy Ste 180
Johnson City, TN 37604
Phone: (423) 794-5540
Fax: (423) 926-3187
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 42204 (TN)

Record details

NPI number1528270816
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 7, 2007
Last updated in NPPESFebruary 21, 2025
Certification dateFebruary 21, 2025

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