Individual
DR. KEVIN GRANT BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5149 N 9TH AVE, SUITE 120, PENSACOLA, FL 32504-8756
(850) 479-1805
(850) 479-1829
Mailing address
PO BOX 11982, PENSACOLA, FL 32524-1982
(850) 479-1805
(850) 479-1829
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
00027045
AL
207P00000X
Emergency Medicine Physician
ME84523
FL
2085R0202X
Diagnostic Radiology Physician
00027045
AL
2085R0202X
Diagnostic Radiology Physician
DR.0065549
CO
2085R0202X
Diagnostic Radiology Physician
Primary
ME84523
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265190400
—
FL
01
—
28018
FLORIDA BLUE
FL
Enumeration date
11/21/2006
Last updated
05/08/2024
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