Individual
DR. BRADLEY GLYNN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4003 KRESGE WAY STE 300, LOUISVILLE, KY 40207-4652
(502) 897-5139
(502) 896-6218
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(022) 534-9245
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
42724
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01062396A
STATE LICENSE
IN
01
—
42724
STATE LICENSE
KY
Enumeration date
08/23/2006
Last updated
03/01/2024
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