Provider Demographics
NPI:1871593814
Name:PARKER, BRIAN D (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:D
Last Name:PARKER
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 1:9724 KINGSTON PIKE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3347
Mailing Address - Country:US
Mailing Address - Phone:865-690-0602
Mailing Address - Fax:865-690-0515
Practice Address - Street 1:7557 DANNAHER WAY
Practice Address - Street 2:SUITE 230
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3558
Practice Address - Country:US
Practice Address - Phone:865-938-5222
Practice Address - Fax:865-938-5264
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000039433208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3328646Medicaid
TN1669416442OtherGROUP NPI
TN4103962OtherBLUE CROSS
TN020253199OtherEEOICP
TN3106070OtherBLUE CROSS
TNCI2260OtherRAILROAD MEDICARE
TN3328646Medicare ID - Type Unspecified
TN3328646Medicaid
TNH29588Medicare UPIN
TN3714759Medicare PIN