# JEREMY BRADLEY MD PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215208608
- **Authorized official:** DR. JEREMY BRADLEY M.D. (OWNER)
- **Authorized official phone:** (270) 684-7362

## Contact information

- **Practice address:** 3122 COMMONWEALTH CT, OWENSBORO, KY 42303-2258
- **Practice address phone:** (270) 684-7362
- **Practice address fax:** (270) 684-7753
- **Mailing address:** 3122 COMMONWEALTH CT, OWENSBORO, KY 42303-2258
- **Mailing address phone:** (270) 684-7362
- **Mailing address fax:** (270) 684-7753

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 31984 | KY | Yes |

## Other

- **Enumeration date:** 01/18/2012
- **Last updated:** 01/26/2012