Provider Demographics
NPI:1235161431
Name:BRINKMAN, PAUL EVERETT (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:EVERETT
Last Name:BRINKMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 465
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-0465
Mailing Address - Country:US
Mailing Address - Phone:731-986-2933
Mailing Address - Fax:731-986-2938
Practice Address - Street 1:3493 VETERANS DR N
Practice Address - Street 2:SUITE C
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-6227
Practice Address - Country:US
Practice Address - Phone:731-986-2933
Practice Address - Fax:731-986-2938
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1391363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3664779Medicaid
TN3664779Medicare PIN