Individual
BRADFORD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
2341 MCCALLIE AVE, SUITE 402, CHATTANOOGA, TN 37404-3239
(423) 698-3309
(423) 624-6355
Mailing address
PO BOX 3549, CHATTANOOGA, TN 37404-0549
(423) 698-3309
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APN8319
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN8319
TN
367500000X
Certified Registered Nurse Anesthetist
RN135716
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1522230
—
TN
01
—
4284396
BLUE CROSS BLUE SHIELD OF TN
TN
01
—
P00904206
RAILROAD MEDICARE
—
Enumeration date
05/29/2007
Last updated
04/20/2011
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