Individual
ROBERT L BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1050 DELAWARE AVE, MARION, OH 43302-6416
(740) 383-7778
(740) 375-8118
Mailing address
# L-3652, COLUMBUS, OH 43260-6052
(740) 383-7927
(740) 383-7942
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA.08134-NA
OH
367500000X
Certified Registered Nurse Anesthetist
NA08134
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2541208
—
OH
Enumeration date
07/11/2006
Last updated
12/07/2016
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