# JEFFREY A BRADLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1639270853
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 150598 | SC | — |
| 2084P0802X | Addiction Psychiatry Physician | 036345 | GA | — |
| 208D00000X | General Practice Physician | 036345 | GA | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 12/23/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1295769438 | GROUP NPI NUMBER | SC |