Healthcare Provider Details

I. General information

NPI: 1306845250
Provider Name (Legal Business Name): BRIAN EUGENE WILHOIT PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 VOLUNTEER BLVD
KNOXVILLE TN
37996-3452
US

IV. Provider business mailing address

DEPARTMENT 888182
KNOXVILLE TN
37996-0001
US

V. Phone/Fax

Practice location:
  • Phone: 865-974-6395
  • Fax: 865-974-0135
Mailing address:
  • Phone: 865-974-6177
  • Fax: 865-974-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP2402
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberP2402
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: