Provider Demographics
NPI:1871787432
Name:FOULK, BROOKE E (MD)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:E
Last Name:FOULK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 19TH ST STE 401
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37916-1831
Mailing Address - Country:US
Mailing Address - Phone:865-541-1122
Mailing Address - Fax:865-541-1976
Practice Address - Street 1:501 19TH ST STE 401
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-1831
Practice Address - Country:US
Practice Address - Phone:865-541-1122
Practice Address - Fax:865-541-1976
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD45692207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3717963OtherGROUP MEDICARE NUMBER