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General NPI Number Information
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NPI Number | 1801845821
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Entity Type | Individual
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Provider Name | BRADLEY PAUL CARTER M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 09/28/2020
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Provider Practice Location Address
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Address Line | 2202 MARTIN LUTHER KING JR AVE
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City | KNOXVILLE
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State | TN
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Zip | 37915-1570
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Country | US
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Telephone | 865-522-6097
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Fax | 865-540-1615
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Provider Business Mailing Address
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Address Line | 6350 W A J HWY DEPARTMENT 100
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City | TALBOTT
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State | TN
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Zip | 37877-8605
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Country | US
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Telephone | 800-355-3565
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Fax | 423-714-2355
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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 | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number | MD0000036304
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License Number State | TN
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