Individual
JONATHAN F. BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 788-4800
(517) 796-6410
Mailing address
DEPATMENT 272801, PO BOX 67000, DETROIT, MI 48267-2728
(517) 841-6913
(517) 841-6917
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01081482A
IN
207P00000X
Emergency Medicine Physician
Primary
4301074228
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104866256
—
MI
01
—
P00315403
RR MEDIACRE
MI
Enumeration date
05/12/2006
Last updated
11/03/2025
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