Individual
DR. JEFFREY D BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, LL, SAINT LOUIS, MO 63110-1032
(314) 454-7236
(314) 362-7769
Mailing address
660 S EUCLID AVE, C B 8224, SAINT LOUIS, MO 63110-1010
(314) 454-7236
(314) 362-7769
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
115804
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209812908
—
MO
05
—
ENROLLED
—
IL
Enumeration date
07/18/2006
Last updated
01/24/2018
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