| David W Brandes Sole Mbr | |
|
2060 Lakeside Centre Way Knoxville TN 37922-6591 | |
| (865) 218-6222 | |
| (865) 218-6220 |
| Full Name | David W Brandes Sole Mbr |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2060 Lakeside Centre Way, Knoxville, Tennessee |
| Authorized Official Name and Position | David W. Brandes (OWNER) |
| Authorized Official Contact | 8652186222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David W Brandes Sole Mbr 2060 Lakeside Centre Way Knoxville TN 37922-6591 Ph: (865) 218-6222 | David W Brandes Sole Mbr 2060 Lakeside Centre Way Knoxville TN 37922-6591 Ph: (865) 218-6222 |
| NPI Number | 1477796837 |
|---|---|
| Provider Enumeration Date | 04/15/2009 |
| Last Update Date | 11/20/2014 |
| Medicare PECOS PAC ID | 9537219977 |
|---|---|
| Medicare Enrollment ID | O20090605000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477796837 | NPI | - | NPPES |
| 44546 | Other | TN | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 44546 (Tennessee) | Primary |
| Provider Name | David W Brandes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487761144 PECOS PAC ID: 4486687167 Enrollment ID: I20090605000545 |
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