Individual
BRADLEY GORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
500 ARCADE AVE STE 320, ELKHART, IN 46514-2477
(574) 523-7900
(574) 523-7909
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-2129
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
02006650A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134562762
—
NY
05
—
300060816
—
IN
Enumeration date
04/13/2013
Last updated
04/28/2023
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