Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD0000013851 | TN |
NPI | 1073855888 |
---|---|
Provider Name | Dr. Walter Howard Brott |
First Address | Knoxville, TN 37920-2821 |
Second Address | Knoxville, TN 37920-2821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2013 |
Last Update Date | 19/03/2013 |