Provider Demographics
NPI:1174055685
Name:BROOKSBANK, JEREMY ALAN (MD)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:ALAN
Last Name:BROOKSBANK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2400 PATTERSON ST STE 502
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6511
Mailing Address - Country:US
Mailing Address - Phone:615-342-7300
Mailing Address - Fax:615-342-7370
Practice Address - Street 1:2400 PATTERSON ST STE 502
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-6511
Practice Address - Country:US
Practice Address - Phone:615-342-7300
Practice Address - Fax:615-342-7370
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN70790207R00000X, 207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease