| Doctor Name: | MR. CHARLES BRILL |
| NPI Number: | 1073698643 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 2746 |
| Business Practice Address: | 650 Joel Drive Blanchfield Army Community Hospital Fort Campbell, KY - 422235349 |
| Business Phone Number: | 2707988727 |
| Business Fax Number: | 2709560180 |
| Mailing Address: | 650 Joel Drive, Blanchfield Army Community Hospital FORT CAMPBELL |
| State: | KY |
| Postal Code: | 422235349 |
| Phone Number: | 2707988727 |
| Fax Number: | 2709560180 |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 08/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 2746 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |