Bradberry, Samuel W

Bradberry, Samuel W is an individual health care provider with primary practice located at 1020 Reelfoot Ave , Union City TN 38261. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bradberry, Samuel W can be contacted via phone (731) 885-5131.

Contact Information

Primary practice address
1020 Reelfoot Ave Union City TN 38261
Phone: (731) 885-5131
Fax: (731) 885-5335
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 14195 Tennessee

Profile Details

NPI number 1588644397
LBN Legal business name Bradberry, Samuel W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Mar 2nd, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588644397 NPPES
Tennessee Other 080091652 RAILROAD MEDICARE
Tennessee MEDICAID 3002040 RAILROAD MEDICARE

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