Healthcare Provider Details

I. General information

NPI: 1023334000
Provider Name (Legal Business Name): ELLIOT BRIN NAVO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 VERMONT AVE
OAK RIDGE TN
37830-6402
US

IV. Provider business mailing address

102 VERMONT AVE
OAK RIDGE TN
37830-6402
US

V. Phone/Fax

Practice location:
  • Phone: 865-835-4500
  • Fax: 865-835-4503
Mailing address:
  • Phone: 865-835-4500
  • Fax: 865-835-4503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number56440
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: