Individual
MR. BRIAN T FRETWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC MPH
Contact information
Practice address
2121 N OCOEE ST, SUITE 101, CLEVELAND, TN 37311-3953
(423) 472-6548
(423) 472-8318
Mailing address
149 HUNTERS RUN TRL NW, CLEVELAND, TN 37312-6205
(423) 650-2987
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1070
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0140208
UNITED HEALTHCARE
TN
01
—
2000307
BCBS OF TN
TN
05
—
3662424
—
TN
01
—
FP62706
WORKERS COMP
TN
01
—
TN0101
JOHN DEERE
TN
Enumeration date
11/20/2006
Last updated
11/20/2007
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