Organization
JEREMY BRADLEY MD PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY BRADLEY M.D. (OWNER)
(270) 684-7362
Entity
Organization
Contact information
Practice address
3122 COMMONWEALTH CT, OWENSBORO, KY 42303-2258
(270) 684-7362
(270) 684-7753
Mailing address
3122 COMMONWEALTH CT, OWENSBORO, KY 42303-2258
(270) 684-7362
(270) 684-7753
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31984
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64319841
—
KY
Enumeration date
01/18/2012
Last updated
01/26/2012
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