MEDICARE: BRADIN EMORY

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	363AM0700X	Medical Physician Assistant	8565	GA

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	:	1295246049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADIN EMORY

Provider Business Mailing Address
First Line	:	2200 HAMILTON RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-8855
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 HAMILTON RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-8855
Country	:	US
Telephone Number	:	706-655-8800
Fax Number	:	678-819-4280

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

Provider Enumeration Date	:	10/19/2017
Last Update Date	:	06/02/2026

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Directions to “ BRADIN EMORY ” Practice Location

Language	Start Address	Practice Location

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