Healthcare Provider Details

I. General information

NPI: 1518981745
Provider Name (Legal Business Name): THOMAS EUGENE BRICKNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNC CAMPUS HEALTH
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

103 OVERLAKE DR
CHAPEL HILL NC
27516-9198
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-3655
  • Fax:
Mailing address:
  • Phone: 919-969-8287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number9601245
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: