Provider Demographics
NPI:1306845250
Name:WILHOIT, BRIAN EUGENE (PHD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:EUGENE
Last Name:WILHOIT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT 888182
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-0001
Mailing Address - Country:US
Mailing Address - Phone:865-974-6177
Mailing Address - Fax:865-974-0135
Practice Address - Street 1:1122 VOLUNTEER BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-3452
Practice Address - Country:US
Practice Address - Phone:865-974-6395
Practice Address - Fax:865-974-0135
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2402103T00000X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3982707Medicaid
TN3982707Medicare ID - Type Unspecified