Irvin, Bradley Allen

Irvin, Bradley Allen is an individual health care provider with primary practice located at 4185 Willow Way , Morristown TN 37814-1611. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Irvin, Bradley Allen can be contacted via phone (423) 248-4972.

Contact Information

Primary practice address
4185 Willow Way Morristown TN 37814-1611
Phone: (423) 248-4972
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 3029 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1629584917
LBN Legal business name Irvin, Bradley Allen
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 21st, 2017
Last updated Jun 14th, 2023 - about last year

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 1629584917 NPPES
South Carolina MEDICAID 3749PA

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