National Provider Identifier Database

BRADLEY POLK WALK IN CLINIC
Rural Health


Contact Information

BRADLEY-POLK WALK-IN CLINIC
119 WHITEWATER DR.
OCOEE, TN37361
Phone: 423-299-9435
Fax: 423-299-9436
Specialty Taxonomy Code
* Rural Health 261QR1300X
Family 363LF0000X
Internal Medicine 207R00000X

* Indicates primary specialty

NPI Profile & details for BRADLEY-POLK WALK-IN CLINIC

NPI Number 1770929333
Legal business name
LBN
BRADLEY-POLK WALK-IN CLINIC
Authorized official TAMI BREHEN - (CO-OWNER)
Entity Organization
Organization subpart No
Enumeration date 05/21/2013
Last updated 11/08/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • TN License #: APN15727
  • TN Medicaid: Q002302

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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