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Individual
DR. BRADLY SHANE HOLLAND
Active
Individual
DR. BRADLY SHANE HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1639
TN
207P00000X
Emergency Medicine Physician
E5111
AR
207Q00000X
Family Medicine Physician
Primary
E-5111
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3300823
—
TN
01
—
4119511
BCBS OF TN
TN
Enumeration date
06/29/2006
Last updated
07/31/2024
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