Individual
DR. BRIAN J. FILLMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1260 GALLAHER RD STE A-C, KINGSTON, TN 37763-4139
(865) 248-8167
(865) 248-8125
Mailing address
1364 INTERSTATE DR STE 101, CROSSVILLE, TN 38555-6187
(931) 456-8880
(931) 456-8883
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1440
TN
111NN1001X
Nutrition Chiropractor
3009
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000393235
ANTHEM BC BS
OH
01
—
5233596
AETNA
OH
01
—
663526
ACN UNITED HEALTH CARE
OH
05
—
Q085835
—
TN
Enumeration date
12/18/2006
Last updated
09/07/2023
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