Provider Demographics
NPI:1235106584
Name:COVINO, BRIAN M (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:M
Last Name:COVINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 OLD WEISGARBER RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1293
Mailing Address - Country:US
Mailing Address - Phone:865-558-4400
Mailing Address - Fax:865-558-4471
Practice Address - Street 1:1422 OLD WEISGARBER RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2674
Practice Address - Country:US
Practice Address - Phone:865-558-4400
Practice Address - Fax:865-558-4471
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN24800207XS0114X
TNMD24800207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1193933OtherUNITED HEALTH CARE
TN3071386OtherBLUE CROSS BLUE SHIELD
TN100010010OtherTENNCARE
TN4465405OtherAETNA
TN200029920OtherRAILROAD MEDICARE
TN3077324Medicaid
TNTN0119OtherJOHN DEERE HEALTHCARE
TNTN0142OtherJOHN DEERE HEALTHCARE
F64794Medicare UPIN
TN3077324Medicaid
TN103I203145Medicare PIN
3077327Medicare ID - Type Unspecified