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General NPI Number Information
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NPI Number | 1326542606
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Entity Type | Individual
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Provider Name | BRIAN R. BRADFORD DO
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Gender | Male
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 250 25TH AVE N STE 300A
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City | NASHVILLE
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State | TN
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Zip | 37203-1632
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Country | US
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Telephone | 615-342-7420
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Fax | 615-342-7429
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Provider Business Mailing Address
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Address Line | 250 25TH AVE N STE 300A
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City | NASHVILLE
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State | TN
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Zip | 37203-1632
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Country | US
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Telephone | 615-342-7420
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Fax | 615-342-7429
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | E-12572
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 12240889-1204
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5252
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License Number State | TN
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