Healthcare Provider Details

I. General information

NPI: 1295246049
Provider Name (Legal Business Name): BRADIN EMORY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2017
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 HAMILTON RD
COLUMBUS GA
31904-8855
US

IV. Provider business mailing address

2200 HAMILTON RD
COLUMBUS GA
31904-8855
US

V. Phone/Fax

Practice location:
  • Phone: 706-655-8800
  • Fax: 678-819-4280
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number8565
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: