Healthcare Provider Details

I. General information

NPI: 1386849263
Provider Name (Legal Business Name): SCOTT BRADFORD HAWES PT, NCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VOI 1215 21ST AVE S SUITE 3312, 3200 MCE SOUTH TOWER
NASHVILLE TN
37232-0001
US

IV. Provider business mailing address

5025 HILLSBORO PIKE 23T
NASHVILLE TN
37215-3743
US

V. Phone/Fax

Practice location:
  • Phone: 615-343-1207
  • Fax:
Mailing address:
  • Phone: 615-343-1207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License NumberPT5337
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: