Individual
JEFFREY A BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
870 CRESTMARK DR STE 203, LITHIA SPRINGS, GA 30122-2665
(470) 881-8757
Mailing address
145 15TH ST NE APT 1235, ATLANTA, GA 30309-3587
(864) 270-7746
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
150598
SC
2084P0802X
Addiction Psychiatry Physician
036345
GA
208D00000X
General Practice Physician
Primary
036345
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295769438
GROUP NPI NUMBER
SC
Enumeration date
09/26/2006
Last updated
12/23/2019
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