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General NPI Number Information
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NPI Number | 1497383806
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Entity Type | Individual
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Provider Name | JAMARCUS TERELL BRIDER DO
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Gender | Male
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 975 E 3RD ST STE C-520
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2163
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Country | US
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Telephone | 423-778-5661
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Fax |
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Provider Business Mailing Address
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Address Line | 4853 WELLESLEY DR
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City | OOLTEWAH
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State | TN
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Zip | 37363-8254
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Country | US
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Telephone | 19-412-2093
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036165732
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 02006590A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 5642
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5642
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E-14984
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License Number State | AR
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Taxonomy #6
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | E-14984
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License Number State | AR
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