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NPI Code Detail

MEDICARE: DR. BRADLEY PAUL CARTER M.D.

MEDICARE: DR. BRADLEY PAUL CARTER M.D.
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
1207RA0000XAdolescent Medicine (Internal Medicine) PhysicianMD0000036304TN

General Provider Information

NPI Number : 1801845821
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRADLEY PAUL CARTER M.D.
Provider Business Mailing Address
First Line : 6350 W A J HWY
Second Line : DEPARTMENT 100
City : TALBOTT
State : TN
Zip : 37877-8605
Country : US
Telephone Number : 800-355-3565
Fax Number : 423-714-2355
Provider Business Practice Location Address
First Line : 2202 MARTIN LUTHER KING JR AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37915-1570
Country : US
Telephone Number : 865-522-6097
Fax Number : 865-540-1615
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2006
Last Update Date : 09/28/2020

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