Healthcare Provider Details

I. General information

NPI: 1811996358
Provider Name (Legal Business Name): JAMES D BRIGGS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 BMH PHYSICIANS OFFICE BLDG
MARYVILLE TN
37804-5807
US

IV. Provider business mailing address

103 W BROADWAY AVE
MARYVILLE TN
37801-4703
US

V. Phone/Fax

Practice location:
  • Phone: 865-980-5260
  • Fax: 865-980-5261
Mailing address:
  • Phone: 865-273-1752
  • Fax: 865-273-1755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number18371
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: