Provider Demographics
NPI:1588664627
Name:BRIG, RAYMOND (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:BRIG
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:PO BOX 52167
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37950-2167
Mailing Address - Country:US
Mailing Address - Phone:865-246-1958
Mailing Address - Fax:865-246-0955
Practice Address - Street 1:1400 DOWELL SPRINGS ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1292
Practice Address - Country:US
Practice Address - Phone:865-246-1958
Practice Address - Fax:865-246-0955
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34595207RH0003X
TNMD0000024684207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103G705079Medicaid
KY64916448Medicaid
TN103G705079Medicare PIN
KYP400033936Medicare PIN
KY64916448Medicaid
TN103G705079Medicaid