MEDICARE: DR. BRAD P WILSON D.O.

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
1	208VP0014X	Interventional Pain Medicine Physician	DO0000002339	TN
2	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	DO0000002339	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205002227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRAD P WILSON D.O.

Provider Business Mailing Address
First Line	:	353 NEW SHACKLE ISLAND RD STE 148C
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-2366
Country	:	US
Telephone Number	:	615-972-1100
Fax Number	:	615-537-4950

Provider Business Practice Location Address
First Line	:	353 NEW SHACKLE ISLAND RD STE 148C
Second Line	:
City	:	HENDERSONVILLE
State	:	TN
Zip	:	37075-2366
Country	:	US
Telephone Number	:	615-972-1100
Fax Number	:	615-537-4950

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	01/09/2024

Similar Medicare Providers

1215908868 — DR. GREGG ANDREW MOTZ MD
Practice Location Address:

353 NEW SHACKLE ISLAND RD STE 141C
HENDERSONVILLE, TN
37075-2366

Practice Phone: 615-826-7171
Practice Fax: 615-826-7170

1578615522 — PAUL J. LEAVITT M.D.
Practice Location Address:

353 NEW SHACKLE ISLAND RD STE 140C
HENDERSONVILLE, TN
37075-2366

Practice Phone: 615-826-5664
Practice Fax: 615-826-5665

1750584710 — DR. THOMAS B TAYLOR JR. M.D.
Practice Location Address:

353 NEW SHACKLE ISLAND RD STE 247C
HENDERSONVILLE, TN
37075-2366

Practice Phone: 615-264-5850
Practice Fax: 615-264-5884

1699029009 — MARGARET LOGAN ANP-BC
Practice Location Address:

353 NEW SHACKLE ISLAND RD STE 148C
HENDERSONVILLE, TN
37075-2366

Practice Phone: 615-972-1100
Practice Fax: 615-537-4950

1285976407 — INTERVENTIONAL PAIN CENTER, PLLC
Practice Location Address:

353 NEW SHACKLE ISLAND RD STE 148C
HENDERSONVILLE, TN
37075-2366

Practice Phone: 615-972-1000
Practice Fax: 615-537-4950

1609218726 — EDITH DEAN FNP
Practice Location Address:

353 NEW SHACKLE ISLAND RD STE 148C
HENDERSONVILLE, TN
37075-2366

Practice Phone: 615-972-1100
Practice Fax: 615-537-4950

Directions to “ DR. BRAD P WILSON D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.