Healthcare Provider Details

I. General information

NPI: 1295771772
Provider Name (Legal Business Name): KEVIN CARL BRINKMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 CLINCH AVE
KNOXVILLE TN
37916-2301
US

IV. Provider business mailing address

PO BOX 15004
KNOXVILLE TN
37901-5004
US

V. Phone/Fax

Practice location:
  • Phone: 865-541-8000
  • Fax:
Mailing address:
  • Phone: 865-541-8895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberMD34290
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: