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Individual

BRADLEY RAY IRVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
2090 S OHIO ST, SALINA, KS 67401-6702
(785) 825-8221
(785) 452-7530
Mailing address
2090 S OHIO ST, SALINA, KS 67401-6702
(785) 825-8221
(785) 452-7530

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0439793
KS
208M00000X
Hospitalist Physician
0439793
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201158740A
KS
Enumeration date
03/30/2014
Last updated
03/19/2020
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