Individual
DR. BRADLEY JAY GAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
207 S MAIN ST., TROY, KS 66087-0547
(785) 985-2211
(785) 985-2444
Mailing address
PO BOX 547, TROY, KS 66087-0547
(785) 985-2211
(785) 985-2444
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
421035
KS
207Q00000X
Family Medicine Physician
R7G07
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058187
BLUE CROSS KS
KS
01
—
060698
BLUE CROSS KS
KS
01
—
10001202700
CHP
KS
01
—
10001202700
CHP
MO
05
—
100147340D
—
KS
05
—
100147340E
—
KS
01
—
16564066
BLUE SHIELD KC
MO
05
—
202430245
—
MO
01
—
2161714
AETNA
—
01
—
P00714641
RR MEDICARE
MO
Enumeration date
08/24/2006
Last updated
10/19/2017
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