Provider Demographics
NPI:1124061676
Name:BRAY, ELIZABETH SMITH (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:SMITH
Last Name:BRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:SMITH
Other - Last Name:BRAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1272 GARRISON DRIVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129
Mailing Address - Country:US
Mailing Address - Phone:615-867-8010
Mailing Address - Fax:615-867-7955
Practice Address - Street 1:1272 GARRISON DRIVE
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129
Practice Address - Country:US
Practice Address - Phone:615-867-8010
Practice Address - Fax:615-867-7955
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19672207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3059586Medicare ID - Type Unspecified
TNE82896Medicare UPIN