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DR. BRADLEY KEITH BROYLES M.D. NPI 1194068684


NPI Profile

NPI: 1194068684
Provider Name: DR. BRADLEY KEITH BROYLES, M.D.
Classification:Emergency Medicine - 207P00000X
Entity Type: Individual
Organization: SPARTANBURG MEDICAL CENTER

PECOS Registration: Yes

Address:
960 E 3RD ST
SUITE 104
CHATTANOOGA, TN
ZIP 37403
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Phone: (865) 778-7628

DR. Bradley Keith Broyles, M.D. is an emergency medicine in Chattanooga, TN with 8 years of experience. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. DR. Bradley Keith Broyles, M.D. NPI is 1194068684. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

960 E 3RD ST
SUITE 104
CHATTANOOGA, TN
ZIP 37403
Phone: (865) 778-7628

The NPI 1194068684 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/3/2013 and was last updated on 12/8/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2207P00000XEmergency Medicine39049SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1390491MEDICAIDSOUTH CAROLINA
2SC85638510OTHERSOUTH CAROLINAMEDICARE PIN
3SC85639068OTHERSOUTH CAROLINAMEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/7/2021

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.