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Individual
DR. BRADLEY JAY GAUL
Active
Individual
DR. BRADLEY JAY GAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
421035
KS
207Q00000X
Family Medicine Physician
R7G07
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058187
BLUE CROSS KS
KS
01
—
060698
BLUE CROSS KS
KS
01
—
10001202700
CHP
KS
01
—
10001202700
CHP
MO
05
—
100147340D
—
KS
05
—
100147340E
—
KS
01
—
16564066
BLUE SHIELD KC
MO
05
—
202430245
—
MO
01
—
2161714
AETNA
—
01
—
P00714641
RR MEDICARE
MO
Enumeration date
08/24/2006
Last updated
10/19/2017
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