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Individual
KEVIN BRADBURY OOTHOUT
Active
Individual
KEVIN BRADBURY OOTHOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD024636
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3122698
BLUE CROSS
TN
01
—
33323
TLC TENNCARE
TN
05
—
3746649
—
TN
05
—
3846640
—
TN
05
—
3846641
—
TN
01
—
4079134
BLUE CROSS
TN
01
—
4079137
BLUE CROSS
TN
01
—
41242
TLC TENNCARE
TN
01
—
P00208403
MEDICARE RAILROAD
TN
01
—
P00222460
MEDICARE RAILROAD
TN
Enumeration date
06/03/2006
Last updated
11/12/2007
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