Healthcare Provider Details

I. General information

NPI: 1376598789
Provider Name (Legal Business Name): GENE WARREN BRATT PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 24TH AVE S
NASHVILLE TN
37212-2637
US

IV. Provider business mailing address

500 CLEAR SPRING CT
BRENTWOOD TN
37027-7650
US

V. Phone/Fax

Practice location:
  • Phone: 613-327-5325
  • Fax: 615-321-6369
Mailing address:
  • Phone: 615-833-7602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number6184
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: