Provider Demographics
NPI:1275585952
Name:BRAZEE, LOUISE J (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:J
Last Name:BRAZEE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:999 EXECUTIVE PARK BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4632
Mailing Address - Country:US
Mailing Address - Phone:423-224-3250
Mailing Address - Fax:423-224-3258
Practice Address - Street 1:135 W RAVINE RD
Practice Address - Street 2:SUITE 5A
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3847
Practice Address - Country:US
Practice Address - Phone:423-224-3760
Practice Address - Fax:423-224-3780
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2008-03-05
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Provider Licenses
StateLicense IDTaxonomies
TN10429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00323570Medicare PIN
B03061Medicare UPIN
TN3164549Medicare PIN