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NPI Code Detail

MEDICARE: MR. SCOTT M. BRAMBLE P.A

MEDICARE: MR. SCOTT M. BRAMBLE P.A
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
1363A00000XPhysician Assistant1881TN
2363AS0400XSurgical Physician Assistant1881TN
3363A00000XPhysician Assistant7098483-1206UT

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P00883990OTHERTNRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24274862OTHERTNBLUECROSS BLUESHIELD
34274863OTHERTNBLUECROSS BLUESHIELD - AT SURGERY

General Provider Information

NPI Number : 1598913022
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SCOTT M. BRAMBLE P.A
Provider Business Mailing Address
First Line : 1932 ALCOA HWY
Second Line : SUITE 360
City : KNOXVILLE
State : TN
Zip : 37920-1527
Country : US
Telephone Number : 865-546-2663
Fax Number : 865-546-9047
Provider Business Practice Location Address
First Line : 3550 N UNIVERSITY AVE STE 250
Second Line :
City : PROVO
State : UT
Zip : 84604-6695
Country : US
Telephone Number : 801-852-9480
Fax Number : 801-852-9489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2008
Last Update Date : 12/10/2024

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