Provider Demographics
NPI:1770760324
Name:DENNIS, BRADLEY M (MD)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:M
Last Name:DENNIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-875-5843
Mailing Address - Fax:615-936-0185
Practice Address - Street 1:1211 21ST AVE S
Practice Address - Street 2:404 MEDICAL ARTS BUILDING
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2717
Practice Address - Country:US
Practice Address - Phone:615-875-5843
Practice Address - Fax:615-936-0185
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA001166208600000X
GA657582086S0102X
TNMD481642086S0102X
TN481642086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care