MEDICARE: GEORGE BINGHAM BROOKS D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	DO717	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110164271	OTHER	TN	RAILROAD MEDICARE
2	3734041	OTHER	TN	MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	0141199	OTHER	TN	MICHIGAN BLUE CROSS
4	100011198	OTHER	TN	PHP
5	141199	OTHER	TN	BLUE CROSS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	5744789	OTHER	TN	AETNA
8	TN0101	OTHER	TN	JOHN DEERE

General Provider Information

NPI Number	:	1881699924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE BINGHAM BROOKS D.O.

Provider Business Mailing Address
First Line	:	8707 ASHEVILLE HWY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37924-4502
Country	:	US
Telephone Number	:	865-933-4159
Fax Number	:	865-933-4065

Provider Business Practice Location Address
First Line	:	8707 ASHEVILLE HWY
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37924-4502
Country	:	US
Telephone Number	:	865-933-4159
Fax Number	:	865-933-4065

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	06/30/2020

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Directions to “ GEORGE BINGHAM BROOKS D.O.” Practice Location

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