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NPI Code Detail

MEDICARE: BRADEN FAMILY MEDICINE, PLLC

MEDICARE: BRADEN FAMILY MEDICINE, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD48081TN
2363A00000XPhysician AssistantPA1510TN

General Provider Information

NPI Number : 1134489024
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRADEN FAMILY MEDICINE, PLLC
Provider Business Mailing Address
First Line : PO BOX 108
Second Line :
City : CORRYTON
State : TN
Zip : 37721-0108
Country : US
Telephone Number : 865-247-6263
Fax Number : 865-247-6418
Provider Business Practice Location Address
First Line : 7701 CORRYTON RD
Second Line :
City : CORRYTON
State : TN
Zip : 37721-2630
Country : US
Telephone Number : 865-247-6263
Fax Number : 865-247-6418
Authorized Official
Title or Position : OWNER/MEMBER
Name : JOE M BRADEN
Credential : PA-C
Telephone Number : 865-247-6263
Provider Enumeration Date : 05/24/2012
Last Update Date : 05/24/2012

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Directions to “BRADEN FAMILY MEDICINE, PLLC ” Practice Location

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