Provider Demographics
NPI:1760468128
Name:BRADY, PAUL C (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:C
Last Name:BRADY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9129 CROSS PARK DR
Mailing Address - Street 2:STE 101
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4505
Mailing Address - Country:US
Mailing Address - Phone:865-694-7725
Mailing Address - Fax:865-692-2353
Practice Address - Street 1:9430 PARK WEST BLVD STE 130
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4205
Practice Address - Country:US
Practice Address - Phone:865-690-4861
Practice Address - Fax:865-560-8525
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2020-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN39661207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3328499Medicaid
TN3328499Medicaid
TN0677340001Medicare NSC
TN0677340002Medicare NSC
I06169Medicare UPIN