Organization
PRODIGAL PRIMARY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID E BRICKHOUSE PA (PA)
(865) 288-3754
Entity
Organization
Contact information
Practice address
598 JOHN DEERE DR, MAYNARDVILLE, TN 37807-3212
(865) 288-3754
(865) 745-1873
Mailing address
2911 ESSARY DR, KNOXVILLE, TN 37918-2468
(865) 394-6706
(865) 394-6719
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/21/2013
Last updated
11/01/2013
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