Provider Demographics
NPI:1689993016
Name:WHEELER, BRIAN JEFFERY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JEFFERY
Last Name:WHEELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1900 N WINSTON RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-3606
Mailing Address - Country:US
Mailing Address - Phone:865-909-0090
Mailing Address - Fax:
Practice Address - Street 1:1900 N WINSTON RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-3606
Practice Address - Country:US
Practice Address - Phone:865-909-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50118208M00000X
TNMD50118207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1532293Medicaid