Individual
DR. ROBERT GRAYDON BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7502 STATE ROAD, SUITE 1180, CINCINNATI, OH 45255-2800
(513) 232-8181
(513) 624-2956
Mailing address
1270 SOLUTIONS CTR, P.O. BOX 771270, CHICAGO, IL 60677-1002
(513) 542-6898
(513) 542-7972
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35077683
OH
208600000X
Surgery Physician
Primary
35-077683
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01417721
AMERIGROUP
OH
05
—
2402939
—
OH
01
—
311527667050
CARESOURCE
OH
01
—
743911
BUCKEYE
OH
01
—
P00931021
RAILROAD MEDICARE
OH
Enumeration date
06/30/2006
Last updated
11/22/2011
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