Provider Demographics
NPI:1194778118
Name:PINKLEY, BRAM I (MD)
Entity type:Individual
Prefix:DR
First Name:BRAM
Middle Name:I
Last Name:PINKLEY
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 1:222 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1870
Mailing Address - Country:US
Mailing Address - Phone:629-255-3486
Mailing Address - Fax:
Practice Address - Street 1:1622 WESTGATE CIR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8019
Practice Address - Country:US
Practice Address - Phone:629-255-2177
Practice Address - Fax:629-255-4235
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN40637208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ017039Medicaid
TN7893530OtherAETNA
TNBP8697510OtherDEA
TN40637OtherMD LICENSE
TN5440739Medicaid
TN40637OtherMD LICENSE
TNBP8697510OtherDEA