Individual
DR. MARK W BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3601 S 6TH AVE, BLDG 90 (4-116D), TUCSON, AZ 85723-0001
(520) 792-1450
(520) 629-1864
Mailing address
3601 S 6TH AVE, BLDG 90 (4-116D), TUCSON, AZ 85723-0001
(520) 792-1450
(520) 629-1864
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01035245A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100052620
—
IN
Enumeration date
04/17/2006
Last updated
07/21/2011
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