Individual
MR. SCOTT M. BRAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A
Contact information
Practice address
3550 N UNIVERSITY AVE STE 250, PROVO, UT 84604-6695
(801) 852-9480
(801) 852-9489
Mailing address
1932 ALCOA HWY, SUITE 360, KNOXVILLE, TN 37920-1527
(865) 546-2663
(865) 546-9047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1881
TN
363A00000X
Physician Assistant
Primary
7098483-1206
UT
363AS0400X
Surgical Physician Assistant
1881
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1520996
—
TN
01
—
4274862
BLUECROSS BLUESHIELD
TN
01
—
4274863
BLUECROSS BLUESHIELD - AT SURGERY
TN
01
—
P00883990
RR MEDICARE
TN
Enumeration date
09/09/2008
Last updated
12/10/2024
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