Provider Demographics
NPI:1396998241
Name:BAZZEL, GRADY JUDSON (MD)
Entity type:Individual
Prefix:DR
First Name:GRADY
Middle Name:JUDSON
Last Name:BAZZEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1552 HIGHWAY 166 N
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TN
Mailing Address - Zip Code:38474-3119
Mailing Address - Country:US
Mailing Address - Phone:931-215-0988
Mailing Address - Fax:615-301-6529
Practice Address - Street 1:448 2ND AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37201-1200
Practice Address - Country:US
Practice Address - Phone:615-862-8611
Practice Address - Fax:615-301-6529
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2024-05-06
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Provider Licenses
StateLicense IDTaxonomies
TXT1646207Q00000X
NY268476207Q00000X
MI4301506264207Q00000X
FLME116130207Q00000X
KY45687207Q00000X
OK31199207Q00000X
ARE-8263207Q00000X
CAC53908207Q00000X
NJ25MA08705100207Q00000X
WY10120A207Q00000X
NC2021-02326207Q00000X
MEEL201612207Q00000X
GA65524207Q00000X
VA0101249511207Q00000X
TN31177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine