Individual
PAUL BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1521 22ND AVE, A, MERIDIAN, MS 39301-4016
(601) 703-3830
(601) 553-2069
Mailing address
PO BOX 2839, MERIDIAN, MS 39302-2839
(601) 703-3480
(601) 703-0124
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
22080
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03735301
—
MS
Enumeration date
08/12/2008
Last updated
09/02/2014
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