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1497383806

NPI Code Detail

MEDICARE: DR. JAMARCUS TERELL BRIDER DO

MEDICARE: DR. JAMARCUS TERELL BRIDER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036165732	IL
2	207R00000X	Internal Medicine Physician	02006590A	IN
3	207RC0000X	Cardiovascular Disease Physician	5642	TN
4	207R00000X	Internal Medicine Physician	5642	TN
5	207R00000X	Internal Medicine Physician	E-14984	AR
6	208D00000X	General Practice Physician	E-14984	AR

General Provider Information

NPI Number	:	1497383806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMARCUS TERELL BRIDER DO

Provider Business Mailing Address
First Line	:	4853 WELLESLEY DR
Second Line	:
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-8254
Country	:	US
Telephone Number	:	19-412-2093
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 E 3RD ST STE C-520
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37403-2163
Country	:	US
Telephone Number	:	423-778-5661
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2020
Last Update Date	:	05/20/2024

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Directions to “ DR. JAMARCUS TERELL BRIDER DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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