Individual
DR. ROGER A BROOKSBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1924 ALCOA HWY, KNOXVILLE, TN 37920-1511
(865) 544-9000
(865) 539-8008
Mailing address
PO BOX 634706, CINCINNATI, OH 45263-0001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
019705
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00496306A
—
GA
01
—
0128420
BLUE CROSS
TN
01
—
3049873
BLUE CROSS
TN
05
—
3073712
—
TN
01
—
3081215
BLUE CROSS
TN
05
—
3817576
—
TN
05
—
3835651
—
TN
05
—
64030901
—
KY
01
—
P00231945
RAILROAD MEDICARE
TN
Enumeration date
07/11/2006
Last updated
04/24/2017
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