Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | MD0000028308 | TN |
NPI | 1245273465 |
---|---|
Provider Name | Brian J. Daley |
First Address | Knoxville, TN 37920-1527 |
Second Address | Knoxville, TN 37920-1527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 15/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3804092 | (05) | TN |