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Individual

BRADLEY THOMAS CORBIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1825 KINGSLEY AVE STE 390, ORANGE PARK, FL 32073-4484
(904) 639-2260
(904) 272-1986
Mailing address
1825 KINGSLEY AVE STE 390, ORANGE PARK, FL 32073-4484
(904) 639-2260
(904) 272-1986

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
5171975
ID
207V00000X
Obstetrics & Gynecology Physician
Primary
ME158618
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100088853
WI
Enumeration date
08/20/2013
Last updated
12/04/2025
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