Individual
DR. MICHAEL BARTON BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3185 W STATE ST, SUITE 2010, BRISTOL, TN 37620-1610
(423) 968-7555
(423) 968-7641
Mailing address
3185 W STATE ST, SUITE 2010, BRISTOL, TN 37620-1610
(423) 968-7555
(423) 968-7641
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
0101056321
VA
207W00000X
Ophthalmology Physician
Primary
29086
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3064606
BLUE CROSS BLUE SHIELD
TN
01
—
382476
ANTHEM
VA
Enumeration date
08/30/2006
Last updated
07/08/2007
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