Individual
DR. BRADLEY SCOTT PUTTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1008 S SPRING AVE, SAINT LOUIS, MO 63110-2520
(314) 977-4717
(314) 977-1877
Mailing address
2215 TURKEY RUN LN, SPRINGFIELD, MO 65809-3554
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
Q1000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001276
—
MO
Enumeration date
07/25/2006
Last updated
01/11/2023
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