Basic Information
Provider Information
NPI: 1811954860
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADAMS
FirstName: BRIAN
MiddleName: JAMES
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1819 CLINCH AVENUE
Address2: SUITE 108
City: KNOXVILLE
State: TN
PostalCode: 379162435
CountryCode: US
TelephoneNumber: 8655465111
FaxNumber: 8655414018
Practice Location
Address1: 1819 CLINCH AVENUE
Address2: SUITE 108
City: KNOXVILLE
State: TN
PostalCode: 379162435
CountryCode: US
TelephoneNumber: 8655465111
FaxNumber: 8655414018
Other Information
ProviderEnumerationDate: 04/26/2006
LastUpdateDate: 06/26/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0011X47323TNY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology

No ID Information.


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