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Individual

BRADLEY JOHNSON LUTTRELL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
90 VERMONT AVE, OAK RIDGE, TN 37830-6478
(865) 482-8890
(865) 482-7400
Mailing address
90 VERMONT AVE, OAK RIDGE, TN 37830-6478
(865) 482-8890
(865) 482-7400

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD0000038353
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3891609
TN
Enumeration date
09/08/2005
Last updated
07/08/2007
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