Individual
DR. BRAD MORRIS MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
310 N L ROGERS WELLS BLVD, GLASGOW, KY 42141-1300
(270) 651-1111
(270) 659-5850
Mailing address
310 N L ROGERS WELLS BLVD, GLASGOW, KY 42141-1300
(270) 651-1111
(270) 659-5850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
43602
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100134820
—
KY
Enumeration date
03/25/2008
Last updated
03/02/2023
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