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Individual

DR. BRADLEY WAYNE HOUSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2603 KENTUCKY AVE, SUITE 302, PADUCAH, KY 42003
(270) 575-4551
(270) 575-4560
Mailing address
PO BOX 9685, PADUCAH, KY 42002-9685
(270) 575-4551
(270) 575-4560

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
33501
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000188608
BCBS
KY
05
64014103
KY
Enumeration date
11/20/2006
Last updated
07/08/2007
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