Provider Demographics
NPI:1366510794
Name:COHEN, BRAD R (MD)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:R
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 440261
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37244-0261
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:
Practice Address - Street 1:3901 CENTRAL PIKE
Practice Address - Street 2:SUITE 153
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-3419
Practice Address - Country:US
Practice Address - Phone:615-391-7320
Practice Address - Fax:615-391-7333
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0672352085R0001X
TNMD263532085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E65795Medicare UPIN
3804414Medicare ID - Type Unspecified