Individual
BRADLEY SCOTT COLLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
911 BYPASS RD BLDG A, PIKEVILLE, KY 41501-1689
(606) 218-3516
(606) 218-4540
Mailing address
PO BOX 432, PIKEVILLE, KY 41502-0432
(606) 218-3516
(606) 218-4540
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
01070211A
IN
2085R0001X
Radiation Oncology Physician
35097980
OH
2085R0001X
Radiation Oncology Physician
Primary
38847
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056084
—
OH
05
—
036119025
—
IL
05
—
201034390
—
IN
01
—
5732211
BLUE CROSS BLUE SHIELD GROUP ID
—
05
—
64087869
—
KY
01
—
DP2506
RAILROAD MEDICARE GROUP PTAN
IL
01
—
IL2288
MEDICARE GROUP PTAN
IL
01
—
P00741224
RAILROAD MEDICARE
IL
01
—
P00987175
MEDICARE RAILROAD
IN
01
—
P00987179
MEDICARE RAILROAD
KY
Enumeration date
06/10/2005
Last updated
09/22/2022
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