Provider Demographics
NPI:1003833963
Name:MCMAHAN, DANIEL BRADFORD (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BRADFORD
Last Name:MCMAHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WINFIELD DUNN PKWY UNIT 160
Mailing Address - Street 2:
Mailing Address - City:SEVIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37876-5570
Mailing Address - Country:US
Mailing Address - Phone:865-366-1546
Mailing Address - Fax:
Practice Address - Street 1:2732 US HIGHWAY 411 S
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-3104
Practice Address - Country:US
Practice Address - Phone:865-681-5277
Practice Address - Fax:865-681-5278
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001989111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
V03155Medicare UPIN
3973301Medicare ID - Type Unspecified