Provider Demographics
NPI:1760412688
Name:BRIN, EDWARD N (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:N
Last Name:BRIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 HUNTERS TRAIL DRIVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069
Mailing Address - Country:US
Mailing Address - Phone:615-376-9112
Mailing Address - Fax:615-376-9113
Practice Address - Street 1:1107 HUNTERS TRAIL DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-7083
Practice Address - Country:US
Practice Address - Phone:956-648-2427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS14717207L00000X
TXE9125207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127650310Medicaid
TXA99084Medicare UPIN
TX127650310Medicaid