Organization
BRADLEY SHORE, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY S SHORE M.D. (OWNER)
(504) 905-2728
Entity
Organization
Contact information
Practice address
107 E SHANKLAND AVE, JENNINGS, LA 70546-4709
(866) 546-6643
(337) 824-4199
Mailing address
107 E SHANKLAND AVE, JENNINGS, LA 70546-4709
(866) 546-6643
(337) 824-4199
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
08/23/2012
Last updated
08/23/2012
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