Look up the most recent NPI and PECOS records

Robert Bradley Canada

Internal Medicine

Allopathic & Osteopathic Physicians

1325 Eastmoreland Ave Ste 445, Memphis, TN 38104-7536

PECOS Enrollment

This provider is enrolled in PECOS as ROBERT CANADA.

Based on the most recent information from CMS, provider Robert Bradley Canada is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1033176250
Provider Type
Individual
Full Name
Canada, Robert Bradley
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
5/1/2006
Last Updated
2/26/2025

Contact Information

Practice Location

1325 Eastmoreland Ave Ste 445, Memphis, TN 38104-7536

(901) 866-8810

(901) 302-2450

Mailing Location

1068 Cresthaven Rd Ste 300, Memphis, TN 38119-0809

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207RN0300X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 32002 Tennessee

Provider Identifiers

ID	Description	Issuer
ID 140694001	Description Medicaid	Issuer Unlisted Arkansas
ID 00122642	Description Medicaid	Issuer Unlisted Mississippi
ID 1033176250	Description Medicaid	Issuer Unlisted Missouri
ID Q003696	Description Medicaid	Issuer Unlisted Tennessee
ID 003181471A	Description Medicaid	Issuer Unlisted Georgia
ID 7100458660	Description Medicaid	Issuer Unlisted Kentucky

Robert Bradley Canada

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer