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Individual

BRADLEY J. MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1600 ACCELERATOR WAY STE 200, KNOXVILLE, TN 37920-3078
(865) 546-2663
(865) 546-9047
Mailing address
8320 E WALKER SPRINGS LN STE 200, KNOXVILLE, TN 37923-3120
(865) 769-4500
(865) 769-4501

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2115
TN
363AS0400X
Surgical Physician Assistant
2115
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528209
TN
01
4323294
BLUECROSS BLUESHIELD
TN
01
4328037
BLUECROSS BLUESHIELD - PA AT SURGERY
TN
01
P01243057
RAILROAD MEDICARE
TN
Enumeration date
03/05/2012
Last updated
01/15/2026
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